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Sample records for artificial bone substitute

  1. [Bone substitutes].

    PubMed

    Jordana, Fabienne; Le Visage, Catherine; Weiss, Pierre

    2017-01-01

    Bone substitutes, used to fill a defect after a surgery or a trauma, provide a mechanical support and might induce bone healing. They constitute an alternative to autogenous bone grafts, the 'gold standard' which remains the reference despite its risk of postoperative complications. The clinician choice of a bone substitute is based on the required bone volume, the handling (injectability, malleability) and mechanical properties (setting time, viscosity, resorbability among others) of the material. Bone substitutes are commonly used in orthopedic surgery, neurosurgery, stomatology and dental applications. Their use increases steadily, with the recent clinical development of injectable forms. In addition, novel technologies by subtractive or additive techniques allow today the production of controlled architecture materials. Here, we present a bone substitutes classification according to their origin (natural or synthetic) and chemical composition, and the most common use of these substitutes. © 2017 médecine/sciences – Inserm.

  2. The Role of Resorbable Plate and Artificial Bone Substitute in Reconstruction of Large Orbital Floor Defect

    PubMed Central

    Kwon, Ho; Kim, Ho Jun; Jeong, Yeon Jin; Jung, Sung-No

    2016-01-01

    It is essential to reduce and reconstruct bony defects adequately in large orbital floor fracture and defect. Among many reconstructive methods, alloplastic materials have attracted attention because of their safety and ease of use. We have used resorbable plates combined with artificial bone substitutes in large orbital floor defect reconstructions and have evaluated their long-term reliability compared with porous polyethylene plate. A total of 147 patients with traumatic orbital floor fracture were included in the study. Surgical results were evaluated by clinical evaluations, exophthalmometry, and computed tomography at least 12 months postoperatively. Both orbital floor height discrepancy and orbital volume change were calculated and compared with preoperative CT findings. The average volume discrepancy and vertical height discrepancies were not different between two groups. Also, exophthalmometric measurements were not significantly different between the two groups. No significant postoperative complication including permanent diplopia, proptosis, and enophthalmos was noted. Use of a resorbable plate with an artificial bone substitute to repair orbital floor defects larger than 2.5 cm2 in size yielded long-lasting, effective reconstruction without significant complications. We therefore propose our approach as an effective alternative method for large orbital floor reconstructions. PMID:27517041

  3. Synchrotron X-ray bioimaging of bone regeneration by artificial bone substitute of MegaGen Synthetic Bone and hyaluronate hydrogels.

    PubMed

    Yeom, Junseok; Chang, Soeun; Park, Jung Kyu; Je, Jung Ho; Yang, Dong Jun; Choi, Seok Kyu; Shin, Hong-In; Lee, Seung-Jae; Shim, Jin-Hyung; Cho, Dong-Woo; Hahn, Sei Kwang

    2010-10-01

    Synchrotron X-ray bioimaging was successfully carried out to observe bone regeneration by a novel artificial bone substitute of bioactive MegaGen Synthetic Bone (MGSB) and hyaluronate (HA) hydrogels. A biphasic calcium phosphate of MGSB was prepared by chemical precipitation method, with a porous spherical morphology. On the basis of the fact that HA plays important roles in bone regeneration and promotes the differentiation, vascularization, and migration of stem cells, HA-cystamine (CYS) hydrogels with cleavable disulfide linkages were prepared to supply HA continuously for effective bone regeneration by their controlled degradation in vivo. Among seven different samples using Bio-OSS®, MGSB, and/or several kinds of HA hydrogels, MGSB/HA-CYS hydrogels resulted in the most significant bone regeneration in the calvarial critical bone defect of New Zealand white rabbits. Histological and histomorphometric analyses revealed that the bone regeneration by MGSB/HA-CYS hydrogels was as high as 43%, occupying 71% of the bone defect area with MGSB in the form of a calvarial bone plate in 4 weeks. After that, MGSB was bioabsorbed and replaced gradually with regenerated bones as observed in 8 weeks. Synchrotron X-ray imaging clearly confirmed the effective bone regeneration by MGSB/HA-CYS hydrogels, showing three-dimensional micron-scale morphologies of regenerated bones interconnected with MGSB. In addition, sequential nondestructive synchrotron X-ray tomographic analysis results from anterior to posterior of the samples were well matched with the histomorphometric analysis results. The clinically feasible artificial bone substitutes of MGSB/HA-CYS hydrogels will be investigated further for various bone tissue engineering applications using the synchrotron X-ray bioimaging systems.

  4. Bone Graft Substitution and Augmentation.

    PubMed

    Nauth, Aaron; Lane, Joseph; Watson, J Tracy; Giannoudis, Peter

    2015-12-01

    Selection of appropriate bone graft or bone graft substitute requires careful recognition of the bone healing needs of the patient's specific clinical problem and a thorough understanding of the different properties possessed by the available bone grafts and substitutes. Although autogenous iliac crest bone graft remains the gold standard of treatment for delayed unions, nonunions, and bone defects, there are a number of promising alternatives available, and emerging evidence suggests that they can be very effective when used in the proper setting. Among these, reamer-irrigator-aspirator bone graft, bone marrow concentrate, bone morphogenetic proteins, and calcium phosphate cements have received a great deal of attention in the literature. This review describes these grafts in detail along with the evidence for their use. In addition, a framework is provided for selecting the appropriate graft or substitute based on their provided properties.

  5. [Progress of bone graft substitute].

    PubMed

    Zhang, Yongguang; Wang, Zhiqiang

    2008-10-01

    To sum up the recent progress of common bone graft substitute and to forecast the possible directions for further research. Recent original articles about investigation and application for bone graft substitute were extensively reviewed. Several common bone graft substitutes were selected and expounded in different categories. Bone graft was an essential treatment in order to provide structural support, fill bone cavity and promote bone defect healing. The gold standard for bone graft was autograft which is subject to many restrictions. In recent years, the research and development of bone graft substitute have received public attention. A very great progress has been made in the research and application of allograft bones, synthetic bones and engineered bones, and some research results have been put into use for real products. There still exist many problems in present bone graft substitutes. Combining various biomaterials and using the specific processing technology to develop a biomaterial which has the similar mechanical and chemical properties and physical structures to autograft so as to promote bone defect healing is the direction for future research.

  6. Substituted hydroxyapatites for bone repair.

    PubMed

    Shepherd, Jennifer H; Shepherd, David V; Best, Serena M

    2012-10-01

    Calcium phosphates such as hydroxyapatite have a wide range of applications both in bone grafts and for the coating of metallic implants, largely as a result of their chemical similarity to the mineral component of bone. However, to more accurately mirror the chemistry, various substitutions, both cationic (substituting for the calcium) and anionic (substituting for the phosphate or hydroxyl groups) have been produced. Significant research has been carried out in the field of substituted apatites and this paper aims to summarise some of the key effect of substitutions including magnesium, zinc, strontium, silicon and carbonate on physical and biological characteristics. Even small substitutions have been shown to have very significant effects on thermal stability, solubility, osteoclastic and osteoblastic response in vitro and degradation and bone regeneration in vivo.

  7. Bone grafts, bone substitutes and orthobiologics

    PubMed Central

    Roberts, Timothy T.; Rosenbaum, Andrew J.

    2012-01-01

    The biology of fracture healing is better understood than ever before, with advancements such as the locking screw leading to more predictable and less eventful osseous healing. However, at times one’s intrinsic biological response, and even concurrent surgical stabilization, is inadequate. In hopes of facilitating osseous union, bone grafts, bone substitutes and orthobiologics are being relied on more than ever before. The osteoinductive, osteoconductive and osteogenic properties of these substrates have been elucidated in the basic science literature and validated in clinical orthopaedic practice. Furthermore, an industry built around these items is more successful and in demand than ever before. This review provides a comprehensive overview of the basic science, clinical utility and economics of bone grafts, bone substitutes and orthobiologics. PMID:23247591

  8. Resorbable calcium phosphate bone substitute.

    PubMed

    Knaack, D; Goad, M E; Aiolova, M; Rey, C; Tofighi, A; Chakravarthy, P; Lee, D D

    1998-01-01

    The in vitro and in vivo properties of a novel, fully resorbable, apatitic calcium phosphate bone substitute (ABS) are described. The ABS was prepared from calcium phosphate precursors that were hydrated to form an injectable paste that hardens endothermically at 37 degrees C to form a poorly crystalline apatitic calcium phosphate (PCA). The PCA reaction product is stable in vivo as determined by FTIR and XRD analysis of rabbit intramuscular implants of ABS retrieved 4, 7, and 14 days postimplantation. Bone formation and resorption characteristics of the ABS material were characterized in a canine femoral slot defect model. Femoral slot defects in dogs were filled with either autologous bone implants or the ABS material. Sections of femoral bone defect site from animals sacrificed at 3, 4, 12, 26, and 52 weeks demonstrated that new bone formation proceeded similarly in both autograft and ABS filled slots. Defects receiving either material were filled with trabecular bone in the first 3 to 4 weeks after implantation; lamellar or cortical bone formation was well established by week 12. New bone formation in ABS filled defects followed a time course comparable to autologous bone graft filled defects. Histomorphometric evaluation of ABS resorption and new bone formation indicated that the ABS material was greater than 99% resorbed within 26 weeks; residual ABS occupied 0.36+/-0.36% (SEM, n = 4) of the original defect area at 26 weeks. Quantitatively and qualitatively, the autograft and ABS were associated with similar new bone growth and defect filling characteristics.

  9. Composite bone substitutes prepared by two methods

    NASA Astrophysics Data System (ADS)

    Lee, Hoe Y.

    A variety of ceramics and polymers exists that can be used as bone substitute materials with desirable properties such as biocompatibility and osteoconductivity. A key feature missing in these bone substitutes, or scaffolds, is the ability to bear loads. This work explored two methods for solving this problem. The first used cancellous bone taken from bovine femoral bone to create a natural scaffold through a heat treating process that eliminated the organic components and sintered the bone minerals, known as hydroxyapatite, together. The strength and Young's modulus of the natural scaffold were greatly improved after polymer infiltration with polymethylmethacrylate. Unfortunately, compression testing revealed that there was not a good interfacial bond between the mineral and polymer phases. The second method employed a freeze-casting technique to create synthetic hydroxyapatite scaffolds that have an aligned lamellar microstructure. By varying the amount of hydroxyapatite in the initial slurry mixture and the cooling rate, synthetic scaffolds with a range of porosities and strengths was produced. The highest solid loading and fastest cooling rate produced a scaffold with a strength and modulus approaching that of cortical bone. Further study is required to produce a two phase composite that is chemically bonded together for optimal performance. The synthetic scaffolds, with their tunable mechanical properties and ease of fabrication, make them a promising material for a load-bearing bone substitute.

  10. 3D Printing of Personalized Artificial Bone Scaffolds

    PubMed Central

    Jariwala, Shailly H.; Lewis, Gregory S.; Bushman, Zachary J.; Adair, James H.

    2015-01-01

    Abstract Additive manufacturing technologies, including three-dimensional printing (3DP), have unlocked new possibilities for bone tissue engineering. Long-term regeneration of normal anatomic structure, shape, and function is clinically important subsequent to bone trauma, tumor, infection, nonunion after fracture, or congenital abnormality. Due to the great complexity in structure and properties of bone across the population, along with variation in the type of injury or defect, currently available treatments for larger bone defects that support load often fail in replicating the anatomic shape and structure of the lost bone tissue. 3DP could provide the ability to print bone substitute materials with a controlled chemistry, shape, porosity, and topography, thus allowing printing of personalized bone grafts customized to the patient and the specific clinical condition. 3DP and related fabrication approaches of bone grafts may one day revolutionize the way clinicians currently treat bone defects. This article gives a brief overview of the current advances in 3DP and existing materials with an emphasis on ceramics used for 3DP of bone scaffolds. Furthermore, it addresses some of the current limitations of this technique and discusses potential future directions and strategies for improving fabrication of personalized artificial bone constructs. PMID:28804734

  11. Major bone defect treatment with an osteoconductive bone substitute.

    PubMed

    Paderni, Stefania; Terzi, S; Amendola, L

    2009-09-01

    A bone defect can be provoked by several pathological conditions (e.g. bone tumours, infections, major trauma with bone stock loss) or by surgical procedures, required for the appropriate treatment. Surgical techniques currently used for treating bone defects may count on different alternatives, including autologous vascularized bone grafts, homologous bone graft provided by musculoskeletal tissue bank, heterologous bone graft (xenograft), or prostheses, each one of them dealing with both specific advantages and complications and drawbacks. The main concerns related to these techniques respectively are: donor site morbidity and limited available amount; possible immune response and viral transmission; possible animal-derived pathogen transmission and risk of immunogenic rejection; high invasiveness and surgery-related systemic risks, long post-operative. physical recovery and prostheses revision need. Nowadays, an ideal alternative is the use of osteoconductive synthetic bone substitutes. Many synthetic substitutes are available, used either alone or in combination with other bone graft. Synthetic bone graft materials available as alternatives to autogeneous bone include calcium sulphates, special glass ceramics (bioactive glasses) and calcium phosphates (calcium hydroxyapatite, HA; tricalcium phosphate, TCP; and biphasic calcium phosphate, BCP). These materials differ in composition and physical properties fro each other and from bone (De Groot in Bioceramics of calcium phosphate, pp 100-114, 1983; Hench in J Am Ceram Soc 74:1487-1510, 1994; Jarcho in Clin Orthop 157:259-278, 1981; Daculsi et al. in Int Rev Cytol 172:129-191, 1996). Both stoichiometric and non-stoichiometric HA-based substitutes represent the current first choice in orthopedic surgery, in that they provide an osteoconductive scaffold to which chemotactic, circulating proteins and cells (e.g. mesenchymal stem cells, osteoinductive growth factors) can migrate and adhere, and within which progenitor

  12. High-strength mineralized collagen artificial bone

    NASA Astrophysics Data System (ADS)

    Qiu, Zhi-Ye; Tao, Chun-Sheng; Cui, Helen; Wang, Chang-Ming; Cui, Fu-Zhai

    2014-03-01

    Mineralized collagen (MC) is a biomimetic material that mimics natural bone matrix in terms of both chemical composition and microstructure. The biomimetic MC possesses good biocompatibility and osteogenic activity, and is capable of guiding bone regeneration as being used for bone defect repair. However, mechanical strength of existing MC artificial bone is too low to provide effective support at human load-bearing sites, so it can only be used for the repair at non-load-bearing sites, such as bone defect filling, bone graft augmentation, and so on. In the present study, a high strength MC artificial bone material was developed by using collagen as the template for the biomimetic mineralization of the calcium phosphate, and then followed by a cold compression molding process with a certain pressure. The appearance and density of the dense MC were similar to those of natural cortical bone, and the phase composition was in conformity with that of animal's cortical bone demonstrated by XRD. Mechanical properties were tested and results showed that the compressive strength was comparable to human cortical bone, while the compressive modulus was as low as human cancellous bone. Such high strength was able to provide effective mechanical support for bone defect repair at human load-bearing sites, and the low compressive modulus can help avoid stress shielding in the application of bone regeneration. Both in vitro cell experiments and in vivo implantation assay demonstrated good biocompatibility of the material, and in vivo stability evaluation indicated that this high-strength MC artificial bone could provide long-term effective mechanical support at human load-bearing sites.

  13. A comparative study of calcium sulfate artificial bone graft versus allograft in the reconstruction of bone defect after tumor curettage.

    PubMed

    Yang, Yongkun; Niu, Xiaohui; Zhang, Qing; Hao, Lin; Ding, Yi; Xu, Hairong

    2014-01-01

    Cavity reconstruction after benign bone tumor removal is varied and controversial. Allograft is widely used but is associated with complications. New bone substitutes, such as calcium sulfate artificial bone, have been introduced for bone tumor operation. However, the bone healing response of artificial bone has not been compared with allograft bone. We therefore compared calcium sulfate grafts (study group) with bone allografts (control group) for the treatment of benign bone tumors. We retrospectively reviewed 50 patients who underwent calcium sulfate reconstruction and 50 patients who underwent allograft cancellous bone reconstruction. The two groups were well matched. The mean follow-up time of the study group was 19.9 (12-55) months. We investigated bone healing response, complications, and factors affecting bone healing. At the last follow-up, 84% (42/50) of cases in the study group and 62% (31/50) of cases in the control group had achieved clinical healing (P = 0.013). The initial healing rate showed no significant difference between the two groups (100% vs. 96%, P = 0.153). The mean healing times for calcium sulfate and allograft bone were 9.6 (3-42) months and 13.8 (3-36) months, respectively (P < 0.01). Complications in the study group were minor and resolved. Implant volume was a significant factor affecting bone healing. The calcium sulfate bone substitute showed a satisfactory healing outcome and safety profile in reconstruction of bone defects after benign bone tumor curettage, especially in smaller cavities.

  14. Artificial Gravity: Effects on Bone Turnover

    NASA Technical Reports Server (NTRS)

    Heer, M.; Zwart, S /R.; Baecker, N.; Smith, S. M.

    2007-01-01

    The impact of microgravity on the human body is a significant concern for space travelers. Since mechanical loading is a main reason for bone loss, artificial gravity might be an effective countermeasure to the effects of microgravity. In a 21-day 6 head-down tilt bed rest (HDBR) pilot study carried out by NASA, USA, the utility of artificial gravity (AG) as a countermeasure to immobilization-induced bone loss was tested. Blood and urine were collected before, during, and after bed rest for bone marker determinations. Bone mineral density was determined by DXA and pQCT before and after bed rest. Urinary excretion of bone resorption markers (n-telopeptide and helical peptide) were increased from pre-bed rest, but there was no difference between the control and the AG group. The same was true for serum c-telopeptide measurements. Bone formation markers were affected by bed rest and artificial gravity. While bone-specific alkaline phosphatase tended to be lower in the AG group during bed rest (p = 0.08), PINP, another bone formation marker, was significantly lower in AG subjects than CN before and during bed rest. PINP was lower during bed rest in both groups. For comparison, artificial gravity combined with ergometric exercise was tested in a 14-day HDBR study carried out in Japan (Iwase et al. J Grav Physiol 2004). In that study, an exercise regime combined with AG was able to significantly mitigate the bed rest-induced increase in the bone resorption marker deoxypyridinoline. While further study is required to more clearly differentiate bone and muscle effects, these initial data demonstrate the potential effectiveness of short-radius, intermittent AG as a countermeasure to the bone deconditioning that occurs during bed rest and spaceflight. Future studies will need to optimize not only the AG prescription (intensity and duration), but will likely need to include the use of exercise or other combined treatments.

  15. Artificial Gravity: Effects on Bone Turnover

    NASA Technical Reports Server (NTRS)

    Heer, M.; Zwart, S /R.; Baecker, N.; Smith, S. M.

    2007-01-01

    The impact of microgravity on the human body is a significant concern for space travelers. Since mechanical loading is a main reason for bone loss, artificial gravity might be an effective countermeasure to the effects of microgravity. In a 21-day 6 head-down tilt bed rest (HDBR) pilot study carried out by NASA, USA, the utility of artificial gravity (AG) as a countermeasure to immobilization-induced bone loss was tested. Blood and urine were collected before, during, and after bed rest for bone marker determinations. Bone mineral density was determined by DXA and pQCT before and after bed rest. Urinary excretion of bone resorption markers (n-telopeptide and helical peptide) were increased from pre-bed rest, but there was no difference between the control and the AG group. The same was true for serum c-telopeptide measurements. Bone formation markers were affected by bed rest and artificial gravity. While bone-specific alkaline phosphatase tended to be lower in the AG group during bed rest (p = 0.08), PINP, another bone formation marker, was significantly lower in AG subjects than CN before and during bed rest. PINP was lower during bed rest in both groups. For comparison, artificial gravity combined with ergometric exercise was tested in a 14-day HDBR study carried out in Japan (Iwase et al. J Grav Physiol 2004). In that study, an exercise regime combined with AG was able to significantly mitigate the bed rest-induced increase in the bone resorption marker deoxypyridinoline. While further study is required to more clearly differentiate bone and muscle effects, these initial data demonstrate the potential effectiveness of short-radius, intermittent AG as a countermeasure to the bone deconditioning that occurs during bed rest and spaceflight. Future studies will need to optimize not only the AG prescription (intensity and duration), but will likely need to include the use of exercise or other combined treatments.

  16. Artificial Sweeteners and Other Sugar Substitutes

    MedlinePlus

    ... American Dietetic Association Complete Food and Nutrition Guide. 4th ed. Hoboken, N.J.: John Wiley & Sons; 2012: ... cancer.gov/cancertopics/factsheet/Risk/artificial-sweeteners. Accessed July 23, 2015. How sweet it is: All about ...

  17. [Bone substitutes used for sinus lift].

    PubMed

    Kamm, T; Kamm, S; Heppt, W

    2015-07-01

    In dental surgery today a variety of bone substitutes are used for sinus lift. After the increased application of synthetics during the last decade there has now been a move back to autologous bone transplants, combined with allogenic and xenogenic augmentation materials. The effects of transforming growth factors and recombinant equivalents of bone morphogenetic proteins remain to be seen. Covering the augmented area with a collagen membrane is the basic standard in many cases. Concomitant illnesses of dental origin or of the maxillary sinus have to be assessed prior to any sinus lift. Once complications such as laceration of the Schneiderian membrane, infection or adverse reaction have occurred, early and consistent therapy is required.

  18. Bioactive behavior of silicon substituted calcium phosphate based bioceramics for bone regeneration.

    PubMed

    Khan, Ather Farooq; Saleem, Muhammad; Afzal, Adeel; Ali, Asghar; Khan, Afsar; Khan, Abdur Rahman

    2014-02-01

    Bone graft substitutes are widely used for bone regeneration and repair in defect sites resulting from aging, disease, trauma, or accident. With invariably increasing clinical demands, there is an urgent need to produce artificial materials, which are readily available and are capable of fast and guided skeletal repair. Calcium phosphate based bioactive ceramics are extensively utilized in bone regeneration and repair applications. Silicon is often utilized as a substituent or a dopant in these bioceramics, since it significantly enhances the ultimate properties of conventional biomaterials such as surface chemical structure, mechanical strength, bioactivity, biocompatibility, etc. This article presents an overview of the silicon substituted bioceramics, which have emerged as efficient bone replacement and bone regeneration materials. Thus, the role of silicon in enhancing the biological performance and bone forming capabilities of conventional calcium phosphate based bioceramics is identified and reviewed.

  19. Preclinical evaluation of injectable bone substitute materials.

    PubMed

    Bongio, Matilde; van den Beucken, Jeroen J J P; Leeuwenburgh, Sander C G; Jansen, John A

    2015-03-01

    Injectable bone substitutes (IBSs) represent an attractive class of ready-to-use biomaterials, both ceramic- and polymer-based, as they offer the potential benefit of minimally invasive surgery and optimal defect filling. Although in vitro assessments are the first step in the process of development, the safety and efficacy of an IBS strongly depend on validated preclinical research prior to clinical trials. However, the selection of a suitable preclinical model for performance evaluation of an IBS remains a challenge, as no gold standard exists to define the best animal model. In order to succeed in this attempt, we identified three stages of development, including (a) proof-of-principle, (b) predictive validity and (c) general scientific legitimacy, and the respective criteria that should be applied for such selection. The second part of this review provides an overview of commonly used animals for IBSs. Specifically, scientific papers published between January 1996 and March 2012 were retrieved that report the use of preclinical models for the evaluation of IBSs in situations requiring bone healing and bone augmentation. This review is meant not only to describe the currently available preclinical models for IBS application, but also to address critical considerations of such multi-factorial evaluation models (including animal species, strain, age, anatomical site, defect size and type of bone), which can be indicative but in most cases edge away from the human reality. Consequently, the ultimate goal is to guide researchers toward a more careful and meaningful interpretation of the results of experiments using animal models and their clinical applications. Copyright © 2012 John Wiley & Sons, Ltd.

  20. Synthesis and characterization of collagen-chitosan-hydroxyapatite artificial bone matrix.

    PubMed

    Wang, Yan; Zhang, Lihai; Hu, Min; Liu, Hongchen; Wen, Weisheng; Xiao, Hongxi; Niu, Yu

    2008-07-01

    In this study, a new artificial bone matrix was constructed with collagen and Ca(5)(PO(4))(3)OH (hydroxyapatite/HA) which are the main components of natural bone. To improve the property of the artificial bone matrix, chitosan (CS), a kind of positive charged polysaccharide, was crosslinked into the scaffolds. Solid-liquid phase separation method was used to shape 3D porous structure benefited for cells growing into. The artificial bone matrix was investigated by transmission electron microscopy, scanning electron microscopy, and electron spectroscopy for chemical analysis, etc. for structures and characteristics. And its ability of bone repair was investigated by orthotope bone defect reparation in vivo. The results showed that the artificial bone matrix was a porousscaffold with three-dimension interconnected fiber microstructure. HA particles were dispersed evenly among collagen fiber and CS was modified on the surface of collagen fiber. It was indicated that this artificial bone matrix could be used as a bone substitute with outstanding properties. (c) 2007 Wiley Periodicals, Inc.

  1. Bioresorbability, porosity and mechanical strength of bone substitutes: what is optimal for bone regeneration?

    PubMed

    Hannink, Gerjon; Arts, J J Chris

    2011-09-01

    Bone repair is a multi-dimensional process that requires osteogenic cells, an osteoconductive matrix, osteoinductive signalling, mechanical stability and vascularization. In clinical practice, bone substitute materials are being used for reconstructive purposes, bone stock augmentation, and bone repair. Over the last decade, the use of calcium phosphate (CaP) based bone substitute materials has increased exponentially. These bone substitute materials vary in composition, mechanical strength and biological mechanism of function, each having their own advantages and disadvantages. It is known that intrinsic material properties of CaP bone substitutes have a profound effect on their mechanical and biological behaviour and associated biodegradation. These material properties of bone substitutes, such as porosity, composition and geometry change the trade-off between mechanical and biological performance. The choice of the optimal bone substitutes is therefore not always an easy one, and largely depends on the clinical application and its associated biological and mechanical needs. Not all bone graft substitutes will perform the same way, and their performance in one clinical site may not necessarily predict their performance in another site. CaP bone substitutes unfortunately have yet to achieve optimal mechanical and biological performance and to date each material has its own trade-off between mechanical and biological performance. This review describes the effect of intrinsic material properties on biological performance, mechanical strength and biodegradability of CaP bone substitutes. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. [Bone substitute. Transplants and replacement materials--an update].

    PubMed

    Rentsch, C; Rentsch, B; Scharnweber, D; Zwipp, H; Rammelt, S

    2012-10-01

    Due to the special characteristics, autologous bone for bone grafting remains the gold standard for defect filling. Besides allogenic bone transplants, as an alternative a set of bone substitutes has been established. An overview of the bone substitutes presently on the market is almost lost due to the abundance of products. The present paper gives a review of the materials available on the market. Different classification systems regarding origin, vitality, biological priority and chemical composition are described as well as the individual materials including the advantages and disadvantages. Finally, a description of tissue engineering and gene therapy gives a view of future prospective.

  3. Synthesis of fluoride-releasing carbonate apatites for bone substitutes.

    PubMed

    Sogo, Yu; Ito, Atsuo; Yokoyama, Daiki; Yamazaki, Atsushi; LeGeros, Racquel Z

    2007-06-01

    Fluoride (F-)-substituted B-type carbonate hydroxyapatite (CHAP) powders were prepared for application as bone substitute materials having the ability to enhance bone formation and to suppress bone resorption due to the therapeutic effect of F-. F- was adsorbed on CHAP in a sodium fluoride solution followed by heating at 700 degrees C in carbon dioxide flow to substitute F- for the hydroxyl ion in the CHAP structure. The F- contents in the F-substituted CHAP powders were 16-22 times greater than that in normal adult human bones. The carbonate ion contents in the F-substituted CHAP powders corresponded to or were higher than that in normal adult human bones. F-substituted CHAP powder with CO3(2-) and F- contents of 11.03 and 0.66 wt%, respectively, slowly released F- in a physiological salt solution to a sufficiently high F- level. The F- concentration slowly increased and reached 67.20 +/- 4.81 microg l(-1), which was 1.5-9.3 times higher than that in the body fluid of normal adult humans, near the therapeutic window of F-, and far lower than the estimated toxic level. Therefore, the F-substituted CHAP can promote bone formation. The present F-substituted CHAP has the advantage of slow F- release over sodium fluoride and sodium monofluorophosphate which are highly soluble salts and cannot be sintered into a ceramic body.

  4. Cell-based resorption assays for bone graft substitutes.

    PubMed

    Zhang, Ziyang; Egaña, José T; Reckhenrich, Ann K; Schenck, Thilo Ludwig; Lohmeyer, Jörn A; Schantz, Jan Thorsten; Machens, Hans-Günther; Schilling, Arndt F

    2012-01-01

    The clinical utilization of resorbable bone substitutes has been growing rapidly during the last decade, creating a rising demand for new resorbable biomaterials. An ideal resorbable bone substitute should not only function as a load-bearing material but also integrate into the local bone remodeling process. This means that these bone substitutes need to undergo controlled resorption and then be replaced by newly formed bone structures. Thus the assessment of resorbability is an important first step in predicting the in vivo clinical function of bone substitute biomaterials. Compared with in vivo assays, cell-based assays are relatively easy, reproducible, inexpensive and do not involve the suffering of animals. Moreover, the discovery of RANKL and M-CSF for osteoclastic differentiation has made the differentiation and cultivation of human osteoclasts possible and, as a result, human cell-based bone substitute resorption assays have been developed. In addition, the evolution of microscopy technology allows advanced analyses of the resorption pits on biomaterials. The aim of the current review is to give a concise update on in vitro cell-based resorption assays for analyzing bone substitute resorption. For this purpose models using different cells from different species are compared. Several popular two-dimensional and three-dimensional optical methods used for resorption assays are described. The limitations and advantages of the current ISO degradation assay in comparison with cell-based assays are discussed.

  5. The Use of Bone Graft Substitute in Hand Surgery

    PubMed Central

    Liodaki, Eirini; Kraemer, Robert; Mailaender, Peter; Stang, Felix

    2016-01-01

    Abstract Bone defects are a very common problem in hand surgery, occurring in bone tumor surgery, in complicated fractures, and in wrist surgery. Bone substitutes may be used instead of autologous bone graft to avoid donor site morbidity. In this article, we will review our experience with the use of Cerament bone void filler (Bonesupport, Lund, Sweden) in elective and trauma hand surgery. A prospective clinical study was conducted with 16 patients treated with this bone graft substitute in our department over a period of 3.5 years. Twelve patients (2 female, 10 male; with an average age of 42.42 years) with monostoic enchondroma of the phalanges were treated and 4 patients (1 female, 3 male; with an average age of 55.25 years) with complicated metacarpal fractures with bone defect. Data such as postoperative course with rating of pain, postoperative complications, functional outcome assessment at 1, 2, 3, 6 months, time to complete remodeling were registered. Postoperative redness and swelling after bone graft substitute use was noticed in 7 patients with enchondroma surgery due to the thin soft-tissue envelope of the fingers. Excellent total active motion of the involved digit was noticed in 10 of 12 enchondroma patients and in all 4 fracture patients at 2-month follow-up. In summary, satisfying results are described, making the use of injectable bone graft substitute in the surgical treatment of enchondromas, as well as in trauma hand surgery a good choice. PMID:27310946

  6. Osteoconduction in keratin-hydroxyapatite composite bone-graft substitutes.

    PubMed

    Dias, George Jayantha; Mahoney, Patricia; Hung, Noelyn Anne; Sharma, Lavanya Ajay; Kalita, Priyakshi; Smith, Robert Allen; Kelly, Robert James; Ali, Azam

    2017-10-01

    Reconstituted keratin-hydroxyapatite (K-HA) composites have shown potential as nonload-bearing bone graft substitute material. This in vivo study investigated the bone regeneration response of keratin plus 40% HA composite materials in comparison to collagen counterparts and an unfilled defect site. The implantation site was a noncritical size defect created in the long bones (tibia) of sheep, with observations made at 1, 2, 4, 6, 8, and 12 weeks postimplantation. Porous K-HA materials displayed an excellent biocompatibility similar to collagen counterparts; however, the rate of bone regeneration at K-HA implantation sites was markedly slower than that of the collagen or unfilled defect sites. While collagen materials were undetectable by 4 weeks implantation, K-HA composite remnants were present at 12 weeks. However, there is evidence that K-HA implants participated in the natural remodelling process of bone, with bone regeneration occurring via a creeping substitution mechanism. Observations imply that the rate of bone ingrowth into the K-HA defect site was matched with the rate of K-HA resorption. These results suggest that K-HA materials may offer significant benefits as nonload-bearing bone graft substitutes where it is desirable that the degradation of the scaffolding material be well matched with the rate of bone regeneration. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2034-2044, 2017. © 2016 Wiley Periodicals, Inc.

  7. An update on bone substitutes for spinal fusion

    PubMed Central

    Miyazaki, Masashi; Tsumura, Hiroshi; Wang, Jeffrey C.

    2009-01-01

    With the current advances in spinal surgery, an understanding of the precise biological mechanism of each bone substitute is necessary for inducing successful spinal fusion. In this review, the categories of bone substitutes include allografts, ceramics, demineralized bone matrix, osteoinductive factors, autogenous platelet concentrate, mesenchymal stem cells, and gene therapy. Further, clinical studies have been evaluated by their levels of evidence in order to elucidate the precise effect of the bone substitute employed and to establish clinical guidance. This article will review both clinical studies based on evidence and basic research in current advances in order to avoid as far as possible any chances of failure in the future and to understand cellular biology in novel technologies. PMID:19280232

  8. [About remodelling in connection with two cases of bone substitution].

    PubMed

    Velich, Norbert; Barabás, József; Szabó, György

    2003-06-01

    Numerous possibilities are available for the reconstruction of facial bone defects. The materials utilized to fill such defects must satisfy various requirements. One of the most important being that they must undergo transformation into autologous bone tissue in the process of remodelling. A report is given of the long-term results of augmentations performed with different bone-substitute materials in two patients. In one case, augmentation was carried out with beta-tricalcium phosphate following the removal of a fibromyxoma. In the second case, three large cystic lesions in the mandible of a patient with Gorlin-Goltz syndrome were filled with beta-tricalcium phosphate, with a mixture of beta-tricalcium phosphate and platelet concentrate, or with hydroxyapatite of algal origin respectively. The process of ossification was checked at 6-months intervals by means of clinical and radiological (orthopantomogramms and 2D and 3D computertomogramms) methods. One year after the intervention, the site of the augmentation was in all cases occupied by hard tissue of good quality. With the given imaging procedures, it was difficult to distinguish between the original bone and the region filled with bone-substitute material. The 3D computertomogramm images indicated that the contours and quality of the new bone corresponded to the physiological and anatomical conditions. The bone-substitute materials applied in these cases fully satisfied the demands of transformation into bone (remodelling).

  9. Interrelationship between bone substitution materials and skeletal muscle tissue.

    PubMed

    Kunert-Keil, Christiane; Botzenhart, Ute; Gedrange, Tomasz; Gredes, Tomasz

    2015-05-01

    Bone density and quantity are primary conditions for the insertion and stability of dental implants. In cases of a lack of adequate maxillary or mandibulary bone, bone augmentation will be necessary. The use of synthetic bioactive bone substitution materials is of increasing importance as alternatives to autogenously bone grafts. It is well known that bone can influence muscle function and muscle function can influence bone structures. Muscles have a considerable potential of adaptation and muscle tissue surrounding an inserted implant or bone surrogate can integrate changes in mechanical load of the muscle and hereupon induce signaling cascades with protein synthesis and arrangement of the cytoskeleton. The Musculus latissimus dorsi is very often used for the analyses of the in vivo biocompatibility of newly designed biomaterials. Beside macroscopically and histologically examination, biocompatibility can be assessed by analyses of the biomaterial influence of gene expression. This review discusses changes in the fiber type distribution, myosin heavy chain isoform composition, histological appearance and vascularization of the skeletal muscle after implantation of bone substitution materials. Especially, the effects of bone surrogates should be described at the molecular-biological and cellular level.

  10. Engineering bone tissue substitutes from human induced pluripotent stem cells.

    PubMed

    de Peppo, Giuseppe Maria; Marcos-Campos, Iván; Kahler, David John; Alsalman, Dana; Shang, Linshan; Vunjak-Novakovic, Gordana; Marolt, Darja

    2013-05-21

    Congenital defects, trauma, and disease can compromise the integrity and functionality of the skeletal system to the extent requiring implantation of bone grafts. Engineering of viable bone substitutes that can be personalized to meet specific clinical needs represents a promising therapeutic alternative. The aim of our study was to evaluate the utility of human-induced pluripotent stem cells (hiPSCs) for bone tissue engineering. We first induced three hiPSC lines with different tissue and reprogramming backgrounds into the mesenchymal lineages and used a combination of differentiation assays, surface antigen profiling, and global gene expression analysis to identify the lines exhibiting strong osteogenic differentiation potential. We then engineered functional bone substitutes by culturing hiPSC-derived mesenchymal progenitors on osteoconductive scaffolds in perfusion bioreactors and confirmed their phenotype stability in a subcutaneous implantation model for 12 wk. Molecular analysis confirmed that the maturation of bone substitutes in perfusion bioreactors results in global repression of cell proliferation and an increased expression of lineage-specific genes. These results pave the way for growing patient-specific bone substitutes for reconstructive treatments of the skeletal system and for constructing qualified experimental models of development and disease.

  11. Correction of alveolar cleft with calcium-based bone substitutes.

    PubMed

    Lazarou, Spiros A; Contodimos, George B; Gkegkes, Ioannis D

    2011-05-01

    The criterion standard of alveolar cleft repair is iliac crest bone graft before secondary canine eruption. Tooth eruption has never been shown to occur in synthetic bone substitute, and there is no ideal autologous bone graft for primary repair. This prospective study evaluated alveolar cleft grafting with a calcium substitute before primary canine eruption. Ten consecutive patients with complete cleft lip, palate, and unilateral alveolar cleft with reasonably aligned arches were grafted beginning in January 2003 to March 2007. Mean age at surgery was 10.4 months. Follow-up ranged from 3 to 7 years. Radiologic evaluation of alveolar ridge was performed at the age of 4.All 10 patients were operated on by the same surgeon using the same technique, that is, conservative elevation of nasal, oral, and anterior alveolar mucosal flaps around the cleft, closure of nasal and oral flaps, placement of 1 to 3 mL of calcium substitute paste or crystals in the pocket, and closure of the anterior alveolar mucosa. All 10 patients healed without complication. Clinical evaluation revealed a well-healed arch with primary canine growth in the area of the previous cleft. Adequate normal bone formation and often a descending secondary canine were radiologically confirmed. Calcium substitutes offer significant advantages over other biomaterials as well as autologous bone grafts particularly in the primary alveolar cleft reconstruction. Our study has shown for the first time that teeth can erupt through this material, which turns into a normal functioning bone in the alveolar ridge.

  12. Pharmacokinetics of gentamicin eluted from a regenerating bone graft substitute

    PubMed Central

    Stravinskas, M.; Horstmann, P.; Ferguson, J.; Hettwer, W.; Tarasevicius, S.; Petersen, M. M.; McNally, M. A.; Lidgren, L.

    2016-01-01

    Objectives Deep bone and joint infections (DBJI) are directly intertwined with health, demographic change towards an elderly population, and wellbeing. The elderly human population is more prone to acquire infections, and the consequences such as pain, reduced quality of life, morbidity, absence from work and premature retirement due to disability place significant burdens on already strained healthcare systems and societal budgets. DBJIs are less responsive to systemic antibiotics because of poor vascular perfusion in necrotic bone, large bone defects and persistent biofilm-based infection. Emerging bacterial resistance poses a major threat and new innovative treatment modalities are urgently needed to curb its current trajectory. Materials and Methods We present a new biphasic ceramic bone substitute consisting of hydroxyapatite and calcium sulphate for local antibiotic delivery in combination with bone regeneration. Gentamicin release was measured in four setups: 1) in vitro elution in Ringer’s solution; 2) local elution in patients treated for trochanteric hip fractures or uncemented hip revisions; 3) local elution in patients treated with a bone tumour resection; and 4) local elution in patients treated surgically for chronic corticomedullary osteomyelitis. Results The release pattern in vitro was comparable with the obtained release in the patient studies. No recurrence was detected in the osteomyelitis group at latest follow-up (minimum 1.5 years). Conclusions This new biphasic bone substitute containing antibiotics provides safe prevention of bone infections in a range of clinical situations. The in vitro test method predicts the in vivo performance and makes it a reliable tool in the development of future antibiotic-eluting bone-regenerating materials. Cite this article: M. Stravinskas, P. Horstmann, J. Ferguson, W. Hettwer, M. Nilsson, S. Tarasevicius, M. M. Petersen, M. A. McNally, L. Lidgren. Pharmacokinetics of gentamicin eluted from a regenerating

  13. Mesenchymal stem cells combined with an artificial dermal substitute improve repair in full-thickness skin wounds.

    PubMed

    Leonardi, Dilmar; Oberdoerfer, Daniel; Fernandes, Marilda C; Meurer, Rosalva T; Pereira-Filho, Gustavo A; Cruz, Paloma; Vargas, Marcelo; Chem, Roberto C; Camassola, Melissa; Nardi, Nance B

    2012-12-01

    Autografts represent the gold standard for the treatment of full thickness burns. Factors such as lack of suitable donor sites and poor skin quality, however, have led to the development of artificial dermal substitutes. The investigation of mechanisms leading to enhanced functionality of these skin substitutes has been attracting great attention. This study aimed to investigate the effect of autologous stem cells on the integration and vascularization of a dermal substitute in full-thickness skin wounds, in a murine model. Two cell populations were compared, whole bone marrow cells and cultivated mesenchymal stem cells, isolated from mice transgenic for the enhanced green fluorescent protein, which allowed tracking of the transplanted cells. The number of cells colonizing the dermal substitute, as well as vascular density, were higher in mice receiving total bone marrow and particularly mesenchymal stem cells, than in control animals. The effect was more pronounced in animals treated with mesenchymal stem cells, which located primarily in the wound bed, suggesting a paracrine therapeutic mechanism. These results indicate that combining mesenchymal stem cells with artificial dermal substitutes may represent an important potential modality for treating full thickness burns, even in allogeneic combinations due to the immunoregulatory property of these cells. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  14. [Identification of osteogenic signal and the development of artificial bones].

    PubMed

    Ohba, Shinsuke; Chung, Ung-il; Tei, Yuichi

    2013-12-01

    Mammalian skeletons are formed through two distinct processes, intramembranous ossification and endochondral ossification. During the endochondral ossification, indian hedgehog (Ihh) /parathyroid hormone-related protein (PTHrP) negative-feedback loop regulates the distance between epiphysis and the layer of hypertrophic chondrocytes. Ihh also stimulates bone formation. Based on such knowledge, bioactive molecule-loaded artificial bones are expected to achieve efficient bone regeneration without cell transplantation.

  15. 3D artificial bones for bone repair prepared by computed tomography-guided fused deposition modeling for bone repair.

    PubMed

    Xu, Ning; Ye, Xiaojian; Wei, Daixu; Zhong, Jian; Chen, Yuyun; Xu, Guohua; He, Dannong

    2014-09-10

    The medical community has expressed significant interest in the development of new types of artificial bones that mimic natural bones. In this study, computed tomography (CT)-guided fused deposition modeling (FDM) was employed to fabricate polycaprolactone (PCL)/hydroxyapatite (HA) and PCL 3D artificial bones to mimic natural goat femurs. The in vitro mechanical properties, in vitro cell biocompatibility, and in vivo performance of the artificial bones in a long load-bearing goat femur bone segmental defect model were studied. All of the results indicate that CT-guided FDM is a simple, convenient, relatively low-cost method that is suitable for fabricating natural bonelike artificial bones. Moreover, PCL/HA 3D artificial bones prepared by CT-guided FDM have more close mechanics to natural bone, good in vitro cell biocompatibility, biodegradation ability, and appropriate in vivo new bone formation ability. Therefore, PCL/HA 3D artificial bones could be potentially be of use in the treatment of patients with clinical bone defects.

  16. Magnesium substitution in brushite cements for enhanced bone tissue regeneration.

    PubMed

    Cabrejos-Azama, Jatsue; Alkhraisat, Mohammad Hamdan; Rueda, Carmen; Torres, Jesús; Blanco, Luis; López-Cabarcos, Enrique

    2014-10-01

    We have synthesized calcium phosphate cements doped with different amounts of magnesium (Mg-CPC) with a twofold purpose: i) to evaluate in vitro the osteoblast cell response to this material, and ii) to compare the bone regeneration capacity of the doped material with a calcium cement prepared without magnesium (CPC). Cell proliferation and in vivo response increased in the Mg-CPCs in comparison with CPC. The Mg-CPCs have promoted higher new bone formation than the CPC (p<0.05). The cytocompatibility and histomorfometric analysis performed in the rabbit calvaria showed that the incorporation of magnesium ions in CPC improves osteoblasts proliferation and provides higher new bone formation. The development of a bone substitute with controllable biodegradable properties and improved bone regeneration can be considered a step toward personalized therapy that can adapt to patient needs and clinical situations. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Novel microinjector for carrying bone substitutes for bone regeneration in periodontal diseases.

    PubMed

    Tsai, Hsiao-Cheng; Li, Yi-Chen; Young, Tai-Horng; Chen, Min-Huey

    2016-01-01

    Traditionally, guide bone regeneration (GBR) was a widely used method for repairing bone lost from periodontal disease. There were some disadvantages associated with the GBR method, such as the need for a stable barrier membrane and a new creative cavity during the surgical process. To address these disadvantages, the purpose of this study was to evaluate a novel microinjector developed for dental applications. The microinjector was designed to carry bone graft substitutes to restore bone defects for bone regeneration in periodontal diseases. The device would be used to replace the GBR method. In this study, the injected force and ejected volume of substitutes (including air, water, and ethanol) were defined by Hooke's law (n = 3). The optimal particle size of bone graft substitutes was determined by measuring the recycle ratio of bone graft substitutes from the microinjector (n = 3). Furthermore, a novel agarose gel model was used to evaluate the feasibility of the microinjector. The current study found that the injected force was less than 0.4 N for obtaining the ejected volume of approximately 2 mL, and when the particle size of tricalcium phosphate (TCP) was smaller than 0.5 mm, 80% TCP could be ejected from the microinjector. Furthermore, by using an agarose model to simulate the periodontal soft tissue, it was also found that bone graft substitutes could be easily injected into the gel. The results confirmed the feasibility of this novel microinjector for dental applications to carry bone graft substitutes for the restoration of bone defects of periodontal disease. Copyright © 2015. Published by Elsevier B.V.

  18. [Properties evaluation of collagen-hydroxyapatite-chondroitin sulfate-bone morphogenetic protein bone substitute material].

    PubMed

    Wang, Hao; Zhang, Li-cheng; Shi, Tao; Xiong, Qi; Tang, Pei-fu

    2011-10-18

    To construct a new 3D porous bone substitute material with collagen, hydroxyapatite and chondroitin sulfate, which has the main components of nature bone and the cell growth factor BMP-2 with bone inductive ability. Collagen-hydroxyapatite-chondroitin sulfate scaffolds were prepared by chemical cross linking and freeze-drying, and bone morphogenetic protein (BMP) was incorporated into the scaffolds by adsorption. The bone substitute material was investigated by HE analysis, scanning electron microscope(SEM), electron spectroscopy for chemical analysis(ESCA), and X-ray diffraction(XRD). Rat mesenchymal stem cells (MSCs) were seeded into the scaffolds and cultured to form cell/scaffold (CS) constructs in vitro. The ectopic osteoinduction of the scaffolds were evaluated in vivo. The bone substitute material had a porous 3D structure facilitating cells growing into it. Implanted into the muscle, the scaffolds were degraded with the forming of new bone. Our Findings indicate that the bone substitute material has good biocompatibility and its attachment to CS could improve the adhesion and differentiation of cells.

  19. Small-animal models for testing macroporous ceramic bone substitutes.

    PubMed

    Le Guehennec, L; Goyenvalle, E; Aguado, E; Houchmand-Cuny, M; Enkel, B; Pilet, P; Daculsi, G; Layrolle, P

    2005-01-15

    The aim of this study was to compare the bone colonization of a macroporous biphasic calcium phosphate (MBCP) ceramic in different sites (femur, tibia, and calvaria) in two animal species (rats and rabbits). A critical size defect model was used in all cases with implantation for 21 days. Bone colonization in the empty and MBCP-filled defects was measured with the use of backscattered electron microscopy (BSEM). In the empty cavities, bone healing remained on the edges, and did not bridge the critical size defects. Bone growth was observed in all the implantation sites in rats (approximately 13.6-36.6% of the total defect area, with ceramic ranging from 46.1 to 51.9%). The bone colonization appeared statistically higher in the femur of rabbits (48.5%) than in the tibia (12.6%) and calvaria (22.9%) sites. This slightly higher degree of bone healing was related to differences in the bone architecture of the implantation sites. Concerning the comparison between animal species, bone colonization appeared greater in rabbits than in rats for the femoral site (48.5% vs. 29.6%). For the other two sites (the tibia and calvaria), there was no statistically significant difference. The increased bone ingrowth observed in rabbit femurs might be due to the large bone surface area in contact with the MBCP ceramics. The femoral epiphysis of rabbits is therefore a favorable model for testing the bone-bonding capacity of materials, but a comparison with other implantation sites is subject to bias. This study shows that well-conducted and fully validated models with the use of small animals are essential in the development of new bone substitutes. Copyright 2004 Wiley Periodicals, Inc.

  20. Microstructure and biomechanical characteristics of bone substitutes for trauma and orthopaedic surgery

    PubMed Central

    2011-01-01

    Background Many (artificial) bone substitute materials are currently available for use in orthopaedic trauma surgery. Objective data on their biological and biomechanical characteristics, which determine their clinical application, is mostly lacking. The aim of this study was to investigate structural and in vitro mechanical properties of nine bone substitute cements registered for use in orthopaedic trauma surgery in the Netherlands. Methods Seven calcium phosphate cements (BoneSource®, Calcibon®, ChronOS®, Eurobone®, HydroSet™, Norian SRS®, and Ostim®), one calcium sulphate cement (MIIG® X3), and one bioactive glass cement (Cortoss®) were tested. Structural characteristics were measured by micro-CT scanning. Compression strength and stiffness were determined following unconfined compression tests. Results Each bone substitute had unique characteristics. Mean total porosity ranged from 53% (Ostim®) to 0.5% (Norian SRS®). Mean pore size exceeded 100 μm only in Eurobone® and Cortoss® (162.2 ± 107.1 μm and 148.4 ± 70.6 μm, respectively). However, 230 μm pores were found in Calcibon®, Norian SRS®, HydroSet™, and MIIG® X3. Connectivity density ranged from 27/cm3 for HydroSet™ to 0.03/cm3 for Calcibon®. The ultimate compression strength was highest in Cortoss® (47.32 MPa) and lowest in Ostim® (0.24 MPa). Young's Modulus was highest in Calcibon® (790 MPa) and lowest in Ostim® (6 MPa). Conclusions The bone substitutes tested display a wide range in structural properties and compression strength, indicating that they will be suitable for different clinical indications. The data outlined here will help surgeons to select the most suitable products currently available for specific clinical indications. PMID:21288333

  1. Guided bone regeneration using resorbable membrane and different bone substitutes: Early histological and molecular events.

    PubMed

    Elgali, Ibrahim; Turri, Alberto; Xia, Wei; Norlindh, Birgitta; Johansson, Anna; Dahlin, Christer; Thomsen, Peter; Omar, Omar

    2016-01-01

    Bone insufficiency remains a major challenge for bone-anchored implants. The combination of guided bone regeneration (GBR) and bone augmentation is an established procedure to restore the bone. However, a proper understanding of the interactions between the bone substitute and GBR membrane materials and the bone-healing environment is lacking. This study aimed to investigate the early events of bone healing and the cellular activities in response to a combination of GBR membrane and different calcium phosphate (CaP) materials. Defects were created in the trabecular region of rat femurs, and filled with deproteinized bovine bone (DBB), hydroxyapatite (HA) or strontium-doped HA (SrHA) or left empty (sham). All the defects were covered with an extracellular matrix membrane. Defects were harvested after 12h, 3d and 6d for histology/histomorphometry, immunohistochemistry and gene expression analyses. Histology revealed new bone, at 6d, in all the defects. Larger amount of bone was observed in the SrHA-filled defect. This was in parallel with the reduced expression of osteoclastic genes (CR and CatK) and the osteoblast-osteoclast coupling gene (RANKL) in the SrHA defects. Immunohistochemistry indicated fewer osteoclasts in the SrHA defects. The observations of CD68 and periostin-expressing cells in the membrane per se indicated that the membrane may contribute to the healing process in the defect. It is concluded that the bone-promoting effects of Sr in vivo are mediated by a reduction in catabolic and osteoblast-osteoclast coupling processes. The combination of a bioactive membrane and CaP bone substitute material doped with Sr may produce early synergistic effects during GBR. The study provides novel molecular, cellular and structural evidence on the promotion of early bone regeneration in response to synthetic strontium-containing hydroxyapatite (SrHA) substitute, in combination with a resorbable, guided bone regeneration (GBR) membrane. The prevailing view, based

  2. Coralline hydroxyapatite bone graft substitutes: preliminary report of radiographic evaluation.

    PubMed

    Sartoris, D J; Gershuni, D H; Akeson, W H; Holmes, R E; Resnick, D

    1986-04-01

    A new bone graft substitute made by conversion of the calcium carbonate exoskeleton of reef-building sea coral into hydroxyapatite has recently become clinically available. The normal radiographic appearance of two forms of this material is described. In the immediate postoperative period, the exoskeletal architecture of these implants is readily appreciated. With graft incorporation over the ensuing months, their intrinsic structure is gradually lost in association with poor marginal definition. Evolving radiographic findings reflect the biocompatible nature of these implants, which provides the potential for ingrowth of native bone with preservation of the coralline scaffold, resulting in enhanced biomechanical properties.

  3. Long-term in vivo experimental investigations on magnesium doped hydroxyapatite bone substitutes.

    PubMed

    Sartori, M; Giavaresi, G; Tschon, M; Martini, L; Dolcini, L; Fiorini, M; Pressato, D; Fini, M

    2014-06-01

    Despite several efforts to find suitable alternatives to autologous bone, no bone substitute currently available provides the same characteristics and properties. Nevertheless, among the wide range of materials proposed as bone substitutes, calcium phosphate materials represent the most promising category and the present study is aimed at improving the knowledge on non-stoichiometric magnesium-doped hydroxyapatite substitutes (Mg-HA), tested in two different formulations: Mg-HA Putty and Mg-HA Granules. These bone substitutes were implanted bilaterally into iliac crest bone defects in healthy sheep and comparative histological, histomorphometric, microhardness and ultrastructural assessments were performed 9, 12, 18 and 24 months after surgery to elucidate bone tissue apposition, mineralization and material degradation in vivo. The results confirmed that the biomimetic bone substitutes provide a histocompatible and osteoconductive structural support, during the bone formation process, and give essential information about the in vivo resorption process and biological behavior of biomimetic bone substitutes.

  4. Development of hybrid type artificial bone marrow using sintered hydroxyapatite.

    PubMed

    Nishihara, K; Tange, T; Hirota, K; Kawase, K

    1994-01-01

    In vivo inducement of hybrid-type artificial bone marrow with hemopoietic inductive microenvironment (HIM) in sintered hydroxyapatite (HA) chamber was carried out. This research is important to disclose the mechanisms of hemopoiesis and is useful for clinical application. In the evolution of vertebrates, cartilage of the inner skeleton changed into bone, having biomechanical properties to form bone marrow cavities. The hemopoietic nests immigrated into the cavities from the spleen. We should be able to induce hemopoietic nests in a hydroxyapatite chamber in place of bone, if we can find optimal structural conditions. Therefore, we tried to artificially induce a hematopoietic field in muscles using sintered porous tubular hydroxyapatite and new type hydroxyapatite plate made by high-pressure gas technique. As a result, not only in the pore sites of tubular hydroxyapatite artificial bone, but at the surface of the new type hydroxyapatite plate implanted in the dorsal muscles, marked differentiation of bone marrow cell clusters of the hematopoietic field could be observed.

  5. The use of bone grafts and bone graft substitutes in pediatric orthopaedics: an overview.

    PubMed

    Gross, Richard H

    2012-01-01

    Bone graft substitutes have become progressively more widely used, and are currently heavily marketed. To make intelligent decisions, a complete knowledge of autograaft and allograft bone healing is essential, including the definition of "sterile". Differences in donor selection and tissue processing may confound the user not familiar with the implications of these different approaches. Specific products include demineralized bone matrix (DBM), specific growth factors (recombinant BMP's), ceramic grafts, and platelet-rich plasma (PRP). There are a number of useful applications of bone graft substitues for pediatric orthopaedists, but the data base is evolving. This paper describes the current status of these products.

  6. Nanophase bone substitute in vivo response to subcutaneous implantation.

    PubMed

    Baskin, Jonathan Z; Vasanji, Amit; McMasters, James; Soenjaya, Yohannes; Barbu, Anca M; Eppell, Steven J

    2012-09-01

    A collagen-apatite composite designed as a load-bearing bone substitute implant is used to characterize the relationship between implant morphology and in vivo behavior. This nanophase bone substitute (NBS) is studied morphologically using a nondestructive imaging technique and biologically using the rodent subcutaneous model. Porosity and pore interconnectivity are correlated with histological outcomes showing cellular invasion occurs with average pore sizes below 100 μm. Crosslinking with D-ribose is shown to affect cellular infiltration in a dose-response manner. These data suggest that collagen-apatite bone substitutes can support cellular infiltration with pore size significantly smaller than 100 μm, an encouraging result regarding development of the NBS into a platform of biomaterials with enhanced mechanical properties. The data also indicate that increasing crosslinking density decreases cellular infiltration of NBS. Thus, modulating mechanical properties of the material by altering crosslink density is likely to produce decreased biological response within the material. Copyright © 2012 Wiley Periodicals, Inc.

  7. Newly developed Sr-substituted alpha-TCP bone cements.

    PubMed

    Pina, S; Torres, P M; Goetz-Neunhoeffer, F; Neubauer, J; Ferreira, J M F

    2010-03-01

    New bone cements made of Sr-substituted brushite-forming alpha-tricalcium phosphate (alpha-TCP) were prepared and characterized in the present work. The quantitative phase analysis and structural refinement of the starting powders and of hardened cements were performed by X-ray powder diffraction and the Rietveld refinement technique. Isothermal calorimetry along with setting time analysis allowed a precise tracing of the setting process of the pastes. The pastes showed exothermic reactions within the first 10-15 min after mixing and further release of heat after about 1h. An apatitic phase formed upon immersion of the hardened cements in simulated body fluid for 15 and 30 days due to the conversion of brushite into apatite confirming their in vitro mineralization capability. The compressive strength of the wet cement specimens decreased with increasing curing time, being higher in the case of Sr-substituted CPC. The results suggest that the newly developed Sr-substituted brushite-forming alpha-TCP cements show promise for uses in orthopaedic and trauma surgery such as in filling bone defects.

  8. Exposed tibial bone after burns: Flap reconstruction versus dermal substitute.

    PubMed

    Verbelen, Jozef; Hoeksema, Henk; Pirayesh, Ali; Van Landuyt, Koenraad; Monstrey, Stan

    2016-03-01

    A 44 years old male patient had suffered extensive 3rd degree burns on both legs, undergoing thorough surgical debridement, resulting in both tibias being exposed. Approximately 5 months after the incident he was referred to the Department of Plastic and Reconstructive Surgery of the University Hospital Gent, Belgium, to undergo flap reconstruction. Free flap surgery was performed twice on both lower legs but failed on all four occasions. In between flap surgery, a dermal substitute (Integra(®)) was applied, attempting to cover the exposed tibias with a layer of soft tissue, but also without success. In order to promote the development of granulation tissue over the exposed bone, small holes were drilled in both tibias with removal of the outer layer of the anterior cortex causing the bone to bleed and subsequently negative pressure wound therapy (NPWT) was applied. The limited granulation tissue resulting from this procedure was then covered with a dermal substitute (Glyaderm(®)), consisting of acellular human dermis with an average thickness of 0.25mm. This dermal substitute was combined with a NPWT-dressing, and then served as an extracellular matrix (ECM), guiding the distribution of granulation tissue over the remaining areas of exposed tibial bone. Four days after initial application of Glyaderm(®) combined with NPWT both tibias were almost completely covered with a thin coating of soft tissue. In order to increase the thickness of this soft tissue cover two additional layers of Glyaderm(®) were applied at intervals of approximately 1 week. One week after the last Glyaderm(®) application both wounds were autografted. The combination of an acellular dermal substitute (Glyaderm(®)) with negative pressure wound therapy and skin grafting proved to be an efficient technique to cover a wider area of exposed tibial bone in a patient who was not a candidate for free flap surgery. An overview is also provided of newer and simpler techniques for coverage of

  9. The Influence of Hyperbaric Oxygen Treatment on the Healing of Experimental Defects Filled with Different Bone Graft Substitutes

    PubMed Central

    Sirin, Yigit; Olgac, Vakur; Dogru-Abbasoglu, Semra; Tapul, Leyla; Aktas, Samil; Soley, Sinan

    2011-01-01

    To assess potential effects of hyperbaric oxygen (HBOT) on artificial bone grafts, β - Tricalcium phosphate (β-TCP) and calcium phosphate coated bovine bone (CPCBB) substitutes were applied to standard bone defects in rat tibiae. The control defects were left empty. Half of the animals received 60 minutes of 2.4 atmosphere absolute (ATA) of HBOT. Rats were sacrificed at one, two and four weeks. Bone healing was assessed histologically and histomorphometrically using light microscopy. The periosteum over the bone defects was examined ultrastructurally. Cardiac blood was collected to determine the serum osteocalcin levels. The HBOT increased new bone formation in the unfilled controls and β-TCP groups and significantly decreased cartilage matrix and fibrous tissue formations in all groups. Active osteoblasts and highly organized collagen fibrils were prominent in the periosteum of β-TCP and control groups. Serum osteocalcin levels also increased with HBOT. The healing of defects filled with CPCBB was similar to the controls and it did not respond to HBOT. These findings suggested that the HBOT had beneficial effects on the healing of unfilled bone defects and those filled with β-TCP bone substitute but not with CPCBB, indicating a material-specific influence pattern of HBOT. PMID:21326954

  10. [Application status of rapid prototyping technology in artificial bone based on reverse engineering].

    PubMed

    Fang, Ao; Zheng, Min; Fan, Ding

    2015-02-01

    Artificial bone replacement has made an important contribution to safeguard human health and improve the quality of life. The application requirements of rapid prototyping technology based on reverse engineering in individualized artificial bone with individual differences are particularly urgent. This paper reviewed the current research and applications of rapid prototyping and reverse engineering in artificial bone. The research developments and the outlook of bone kinematics and dynamics simulation are also introduced.

  11. Finite element representation of bone substitute remodelling in the jaw bone.

    PubMed

    Gedrange, Tomasz; Mai, Ronald; Weingaertner, Jens; Hietschold, Volker; Bourauel, Christoph; Pradel, Winnie; Lauer, Günter; Proff, Peter

    2008-10-01

    The finite element (FE) method was originally developed on a physical basis for the computation of structure-mechanical problems. Meanwhile, it has been widely applied to medical issues. This study sought a suitable method to build a FE model for remodelling processes in osseous defects supplemented with bone substitute material. For this purpose, the second right premolars were extracted from four pig mandibles (Sus scrofa domesticus) and the extraction alveoli were provided with synthetic bone substitute material. After 70 days, a segmented osteotomy of this area was performed for specimen collection. Radiographs of the specimens were taken in defined planes before and after fixation and embedded with Technovit 9100. Fixation-related shrinkage was quantified from the radiographs using reference lines. Computer tomographic (CT) and microCT images of the fixed and embedded specimens were obtained. From these data, a FE model was built. The construction of a FE model is sufficient to represent bone remodelling after supply of bone substitute material. The use of microCT data permits building a clearly more precise model.

  12. Radially and Axially Graded Multizonal Bone Graft Substitutes Targeting Critical-Sized Bone Defects from Polycaprolactone/Hydroxyapatite/Tricalcium Phosphate

    PubMed Central

    Ergun, Asli; Yu, Xiaojun; Valdevit, Antonio; Ritter, Arthur

    2012-01-01

    Repair and regeneration of critical sized defects via the utilization of polymeric bone graft substitutes are challenges. Here, we introduce radially and axially graded multizonal bone graft substitutes fabricated from polycaprolactone (PCL), and PCL biocomposites with osteoconductive particles, that is, hydroxyapatite (HA), and β-tricalcium phosphate (TCP). The novel bone graft substitutes should provide a greater degree of freedom to the orthopedic surgeon especially for repair of critically sized bone defects. The modulus of the graft substitute could be tailored in the axial direction upon the systematic variation of the HA/TCP concentration, while in the radial direction the bone graft substitute consisted of an outer layer with high stiffness, encapsulating a softer core with greater porosity. The biocompatibility of the bone graft substitutes was investigated using in vitro culturing of human bone marrow-derived stromal cells followed by the analysis of cell proliferation and differentiation rates. The characterization of the tissue constructs included the enzymatic alkaline phosphates (ALP) activity, microcomputed tomography imaging, and polymerase chain reaction analysis involving the expressions of bone markers, that is, Runx2, ALP, collagen type I, osteopontin, and osteocalcin, overall demonstrating the differentiation of bone marrow derived stem cells (BMSCs) via osteogenic lineage and formation of mineralized bone tissue. PMID:22764839

  13. PDGFBB promotes PDGFR{alpha}-positive cell migration into artificial bone in vivo

    SciTech Connect

    Yoshida, Shigeyuki; Iwasaki, Ryotaro; Kawana, Hiromasa; Miyauchi, Yoshiteru; Hoshi, Hiroko; Miyamoto, Hiroya; Mori, Tomoaki; Kanagawa, Hiroya; Katsuyama, Eri; Fujie, Atsuhiro; Hao, Wu; and others

    2012-05-18

    Highlights: Black-Right-Pointing-Pointer We examined effects of PDGFBB in PDGFR{alpha} positive cell migration in artificial bones. Black-Right-Pointing-Pointer PDGFBB was not expressed in osteoblastic cells but was expressed in peripheral blood cells. Black-Right-Pointing-Pointer PDGFBB promoted PDGFR{alpha} positive cell migration into artificial bones but not osteoblast proliferation. Black-Right-Pointing-Pointer PDGFBB did not inhibit osteoblastogenesis. -- Abstract: Bone defects caused by traumatic bone loss or tumor dissection are now treated with auto- or allo-bone graft, and also occasionally by artificial bone transplantation, particularly in the case of large bone defects. However, artificial bones often exhibit poor affinity to host bones followed by bony union failure. Thus therapies combining artificial bones with growth factors have been sought. Here we report that platelet derived growth factor bb (PDGFBB) promotes a significant increase in migration of PDGF receptor {alpha} (PDGFR{alpha})-positive mesenchymal stem cells/pre-osteoblastic cells into artificial bone in vivo. Growth factors such as transforming growth factor beta (TGF{beta}) and hepatocyte growth factor (HGF) reportedly inhibit osteoblast differentiation; however, PDGFBB did not exhibit such inhibitory effects and in fact stimulated osteoblast differentiation in vitro, suggesting that combining artificial bones with PDGFBB treatment could promote host cell migration into artificial bones without inhibiting osteoblastogenesis.

  14. Development of bioactive materials using reticulated ceramics for bone substitute

    NASA Astrophysics Data System (ADS)

    Jiang, Gengwei

    For hard tissue prosthetics, it is necessary to seek novel synthesis routes by which a real structural bone can be simulated in terms of bioactivity, porosity, and mechanical behavior. The work presented here deals with the development of such a component by a novel synthesis route for bone implantation. To enhance the mechanical properties, an industrial alumina has been selected as the substrate. Alumina is not only bio inert but also mechanically strong which makes it an ideal substrate for bone substitute. The high porosity is achieved via a sponge technique by which both pore size and density can be changed easily. The bioactivity is induced by coating a highly bioactive HA film onto the inner pore surfaces of the reticulated alumina. Based on this concept, the research has focused on the coating of HA onto inner pore surfaces of the reticulated alumina via several effective methods that are developed in our laboratory. No previous studies have so far been reported on coating inner surfaces of small-diameter pores ranging from 0.1--1.0 mm. The key materials processing issues dealt with in this work include precursor chemistry, coating procedures, synthesis of coated component, interface structure study, film adhesion strength testing, and mechanical properties of the component. This novel approach has shown great promise in synthesizing bone substitutes. To determine the applicability of the coated component in hard tissue prosthetics, a bioactivity study has been carried out. By immersing the synthetic HA into simulated body fluid (SBF), the bioresponse has been measured for a variety of samples with different processing conditions. Fundamental aspects of this study are centered on the effects of structural characteristics of HA on the bioactivity. Based on extensive IR and XRD experimental data, it has been found that the bioactivity of HA is sensitively controlled by the structural crystallinity of the HA and its specific surface area. Furthermore, based on

  15. Osteoinductive nanohydroxyapatite bone substitute prepared via in situ hydrothermal transformation of cuttlefish bone.

    PubMed

    Hongmin, Li; Wei, Zhou; Xingrong, Yan; Jing, Wei; Wenxin, Geng; Jihong, Cui; Xin, Xie; Fulin, Chen

    2015-05-01

    The capacity to induce a rapid and controlled healing of bone defects is critical for a bone substitute. Previous studies have reported hydrothermal transformation (HT) of aragonite from cuttlebone (CB) to cuttlebone hydroxyapatite (CBHA). However, the biocompatibility and in vivo characteristic of CBHA have not been fully investigated. We fabricated CBHA via the in situ HT of aragonite from CB. This CBHA exhibited a highly porous structure and nanoscaled surface morphology with a significantly higher protein adsorption rate than CB. Marrow mesenchymal stem cells (MSCs) were seeded and cultured on the CBHA and CB to evaluate their influence on cell proliferation and differentiation. According to scanning electronic microscopy observation and MTT assay, the MSCs adhered and proliferated well on both the CBHA and CB. Compared with the cells on the CB, the MSCs on CBHA exhibited enhanced alkaline phosphatase activity and osteocalcin levels after 13 days of culture. In vivo testing revealed that CBHA could induce ectopic bone formation after implantation, while no bone formation being observed in the CB. These findings demonstrated that a nanoscaled and osteoinductive bone substitute could be produced by hydrothermally transforming an aragonite of CB into a hydroxyapatite. © 2014 Wiley Periodicals, Inc.

  16. Evaluation of a novel silicate substituted hydroxyapatite bone graft substitute in a rabbit posterolateral fusion model.

    PubMed

    Fredericks, Douglas C; Petersen, Emily B; Sahai, Nikhil; Corley, Katherine Gibson N; DeVries, Nicole; Grosland, Nicole M; Smucker, Joseph D

    2013-01-01

    Randomized, controlled study in a laboratory setting. Blinded observations/assessment of study outcomes. The purpose of this study is to determine the performance characteristics of a novel silicate-substituted hydroxyapatite bone graft substitute (BGS), SiCaP EP (Baxter Healthcare/ ApaTech, Elstree, UK), in a stand-alone mode, a stand-alone with bone marrow aspirate (BMA) mode, and an extender mode with iliac crest autograft (ICBG) in a rabbit posterolateral spine fusion model. The investigational BGS is compared to a standard iliac crest autograft (ICBG) control. The rabbit posterolateral fusion model is an established environment for testing of fusion efficacy. It offers the opportunity to obtain radiographic, histological, and biomechanical data on novel bone graft substitutes. One hundred and twenty rabbits were entered into the study with 116 used for analysis. Bilateral posterolateral lumbar intertransverse fusions were performed at L5-L6. The lateral two thirds of the transverse processes were decorti cated and covered with graft material in the following five groups: ICBG, SiCaP EP stand-alone, SiCaP EP with BMA (1:0.5 by volume), and SiCaP EP with ICBG (1:3 by volume). Rabbits were necropsied at 4, 8, and 12-week time points and fusion rate, quantity, and quality was evaluated based on manual palpation, mechanical stiffness testing, pqCT, and histological assessment. SiCaP EP, ICBG+SiCaP EP (3:1), and SiCaP EP+BMA (1:0.5) compare favorably to iliac crest autologous bone by multiple metrics in this rabbit posterolateral fusion model. Fusion efficacy via manual palpation and mechanical stiffness testing metrics indicate that all SiCaP EP groups had similar group-to-group performance, and were not significantly different than the ICBG control at each time period evaluated. In this commonly used rabbit posterolateral fusion model, SiCaP EP utilized as a stand-alone, as a stand-alone with BMA, and as an autograft (ICBG) extender produces results that are

  17. The issue of bioresorption of the Bio-Oss xenogeneic bone substitute in bone defects.

    PubMed

    Duda, Mariusz; Pajak, Jacek

    2004-01-01

    Bone grafts and bone substitute biomaterial implemented in guided tissue regeneration should undergo the process of biological decomposition in the recipient's system. The aim of this work is the presentation of current views concerning the issue of Bio-Oss bovine bone bioresorption and their juxtaposition with the results of the author's own research. The work presents histopathological and immunohistochemical tests of the xenogeneic Bio-Oss preparation from biopsies carried out 30 months after implantation. It was observed that the preparations contained correct bone neighbouring remnant particles of Bio-Oss, intratrabecular fibromatosis around the implant, abundant vascularisation, absence of osteoid and of active inflammatory process. A small number of T and B lymphocytes was detected. The results obtained in the above-described case testify to the descending character of the inflammatory infiltration 30 months after the implementation of Bio-Oss and efficient restoration of the bone. The prevalent view in literature is that Bio-Oss is resorbable biomaterial. However, there are also reports questioning this view as remnants of Bio-Oss have been detected even 44 months after implantation into the bone defect. In the author's own cases, Bio-Oss remnants could be observed 30 months after implanting. It seems that although the creation of new bone structure is indisputable, the process of biological decomposition of Bio-Oss should be described as slow bioresorption.

  18. Tobramycin exposure from active calcium sulfate bone graft substitute.

    PubMed

    Livio, Françoise; Wahl, Peter; Csajka, Chantal; Gautier, Emanuel; Buclin, Thierry

    2014-03-04

    Bone graft substitute such as calcium sulfate are frequently used as carrier material for local antimicrobial therapy in orthopedic surgery. This study aimed to assess the systemic absorption and disposition of tobramycin in patients treated with a tobramycin-laden bone graft substitute (Osteoset® T). Nine blood samples were taken from 12 patients over 10 days after Osteoset® T surgical implantation. Tobramycin concentration was measured by fluorescence polarization. Population pharmacokinetic analysis was performed using NONMEM to assess the average value and variability (CV) of pharmacokinetic parameters. Bioavailability (F) was assessed by equating clearance (CL) with creatinine clearance (Cockcroft CLCr). Based on the final model, simulations with various doses and renal function levels were performed. (ClinicalTrials.gov number, NCT01938417). The patients were 52 +/- 20 years old, their mean body weight was 73 +/- 17 kg and their mean CLCr was 119 +/- 55 mL/min. Either 10 g or 20 g Osteoset® T with 4% tobramycin sulfate was implanted in various sites. Concentration profiles remained low and consistent with absorption rate-limited first-order release, while showing important variability. With CL equated to CLCr, mean absorption rate constant (ka) was 0.06 h-1, F was 63% or 32% (CV 74%) for 10 and 20 g Osteoset® T respectively, and volume of distribution (V) was 16.6 L (CV 89%). Simulations predicted sustained high, potentially toxic concentrations with 10 g, 30 g and 50 g Osteoset® T for CLCr values below 10, 20 and 30 mL/min, respectively. Osteoset® T does not raise toxicity concerns in subjects without significant renal failure. The risk/benefit ratio might turn unfavorable in case of severe renal failure, even after standard dose implantation.

  19. Tobramycin exposure from active calcium sulfate bone graft substitute

    PubMed Central

    2014-01-01

    Background Bone graft substitute such as calcium sulfate are frequently used as carrier material for local antimicrobial therapy in orthopedic surgery. This study aimed to assess the systemic absorption and disposition of tobramycin in patients treated with a tobramycin-laden bone graft substitute (Osteoset® T). Methods Nine blood samples were taken from 12 patients over 10 days after Osteoset® T surgical implantation. Tobramycin concentration was measured by fluorescence polarization. Population pharmacokinetic analysis was performed using NONMEM to assess the average value and variability (CV) of pharmacokinetic parameters. Bioavailability (F) was assessed by equating clearance (CL) with creatinine clearance (Cockcroft CLCr). Based on the final model, simulations with various doses and renal function levels were performed. (ClinicalTrials.gov number, NCT01938417). Results The patients were 52 +/− 20 years old, their mean body weight was 73 +/− 17 kg and their mean CLCr was 119 +/− 55 mL/min. Either 10 g or 20 g Osteoset® T with 4% tobramycin sulfate was implanted in various sites. Concentration profiles remained low and consistent with absorption rate-limited first-order release, while showing important variability. With CL equated to CLCr, mean absorption rate constant (ka) was 0.06 h-1, F was 63% or 32% (CV 74%) for 10 and 20 g Osteoset® T respectively, and volume of distribution (V) was 16.6 L (CV 89%). Simulations predicted sustained high, potentially toxic concentrations with 10 g, 30 g and 50 g Osteoset® T for CLCr values below 10, 20 and 30 mL/min, respectively. Conclusions Osteoset® T does not raise toxicity concerns in subjects without significant renal failure. The risk/benefit ratio might turn unfavorable in case of severe renal failure, even after standard dose implantation. PMID:24593819

  20. Effect of steroidal saponins-loaded nano-bioglass/phosphatidylserine/collagen bone substitute on bone healing.

    PubMed

    Yang, Chunrong; Wu, Huazhong; Wang, Jianhua

    2016-11-10

    The objective of this study was to investigate the therapeutic potential of nano-bioglass/phosphatidylserine/collagen (nBG/PS/COL) scaffolds loaded with steroidal saponins as an inducer factor for skeletal defects. The drugs-encapsulated bone substitute was prepared by loading steroidal saponins-collagen microsphere suspension in nano-bioglass and phosphatidylserine (PS) composite. The scaffolds possess an interconnected porous structure with a porosity of about 82.3%. The pore size ranges from several micrometers up to about 400 μm. The drug release assays showed the long-term sustained release of steroidal saponins from the scaffolds with effective and safe bioactivity. Moreover, in vitro and in vivo studies showed that the involvement of steroidal saponins contributed to the secretion of nerve growth factor (NGF) in MC3T3-E1 cells, which may be the possible factor that greatly enhanced bone healing. The results suggest that the bone substitute is an effective implantable drug-delivery system for use in bone repair.

  1. Artificial Blood Substitutes: First Steps on the Long Route to Clinical Utility

    PubMed Central

    Moradi, Samira; Jahanian-Najafabadi, Ali; Roudkenar, Mehryar Habibi

    2016-01-01

    The 21st century is challenging for human beings. Increased population growth, population aging, generation of new infectious agents, and natural disasters are some threatening factors for the current state of blood transfusion. However, it seems that science and technology not only could overcome these challenges but also would turn many human dreams to reality in this regard. Scientists believe that one of the future evolutionary innovations could be artificial blood substitutes that might pave the way to a new era in transfusion medicine. In this review, recent status and progresses in artificial blood substitutes, focusing on red blood cells substitutes, are summarized. In addition, steps taken toward the development of artificial blood technology and some of their promises and hurdles will be highlighted. However, it must be noted that artificial blood is still at the preliminary stages of development, and to fulfill this dream, ie, to routinely transfuse artificial blood into human vessels, we still have to strengthen our knowledge and be patient. PMID:27812292

  2. Artificial Blood Substitutes: First Steps on the Long Route to Clinical Utility.

    PubMed

    Moradi, Samira; Jahanian-Najafabadi, Ali; Roudkenar, Mehryar Habibi

    2016-01-01

    The 21st century is challenging for human beings. Increased population growth, population aging, generation of new infectious agents, and natural disasters are some threatening factors for the current state of blood transfusion. However, it seems that science and technology not only could overcome these challenges but also would turn many human dreams to reality in this regard. Scientists believe that one of the future evolutionary innovations could be artificial blood substitutes that might pave the way to a new era in transfusion medicine. In this review, recent status and progresses in artificial blood substitutes, focusing on red blood cells substitutes, are summarized. In addition, steps taken toward the development of artificial blood technology and some of their promises and hurdles will be highlighted. However, it must be noted that artificial blood is still at the preliminary stages of development, and to fulfill this dream, ie, to routinely transfuse artificial blood into human vessels, we still have to strengthen our knowledge and be patient.

  3. Lubrication of saliva substitutes at enamel-to-enamel contacts in an artificial mouth.

    PubMed

    Reeh, E S; Douglas, W H; Levine, M J

    1996-06-01

    Mechanisms of salivary lubrication can be quantitatively measured by a reduction in the coefficient of friction. It is important that lubrication be assessed under the conditions of the oral cavity to properly assess lubrication regimes. The relative lubricity of three artificial salivas and two controls were assessed at a bovine enamel interface in an artificial mouth with a range of conditions that approximate oral function. Statistical analysis indicated that the enamel lubricity of sodium dodecylsulfate (SDS) and Oracare-D saliva substitutes were different from the other saliva substitutes and water. The low friction with Oracare-D and SDS saliva substitutes was because of resident amphipaths adsorbed at the enamel interface. Amphipaths adsorbed on enamel may provide a reduction in interocculsal friction and its resulting complications for patients with xerostomia.

  4. Artificial Gravity as a Bone Loss Countermeasure in Simulated Weightlessness

    NASA Technical Reports Server (NTRS)

    Smith, S. M.; Zwart, S. R.; Crawford, G. E.; Gillman, P. L.; LeBlanc, A.; Shackelford, L. C.; Heer, M. A.

    2007-01-01

    The impact of microgravity on the human body is a significant concern for space travelers. We report here initial results from a pilot study designed to explore the utility of artificial gravity (AG) as a countermeasure to the effects of microgravity, specifically to bone loss. After an initial phase of adaptation and testing, 15 male subjects underwent 21 days of 6 head-down bed rest to simulate the deconditioning associated with space flight. Eight of the subjects underwent 1 h of centrifugation (AG, 1 gz at the heart, 2.5 gz at the feet) each day for 21 days, while 7 of the subjects served as untreated controls (CN). Blood and urine were collected before, during, and after bed rest for bone marker determinations. At this point, preliminary data are available on the first 8 subjects (6 AG, and 2 CN). Comparing the last week of bed rest to before bed rest, urinary excretion of the bone resorption marker n-telopeptide increased 95 plus or minus 59% (mean plus or minus SD) in CN but only 32 plus or minus 26% in the AG group. Similar results were found for another resorption marker, helical peptide (increased 57 plus or minus 0% and 35 plus or minus 13% in CN and AG respectively). Bone-specific alkaline phosphatase, a bone formation marker, did not change during bed rest. At this point, sample analyses are continuing, including calcium tracer kinetic studies. These initial data demonstrate the potential effectiveness of short-radius, intermittent AG as a countermeasure to the bone deconditioning that occurs during bed rest.

  5. Artificial Gravity as a Bone Loss Countermeasure in Simulated Weightlessness

    NASA Technical Reports Server (NTRS)

    Smith, S. M.; Zwart, S. R.; Crawford, G. E.; Gillman, P. L.; LeBlanc, A.; Shackelford, L. C.; Heer, M. A.

    2007-01-01

    The impact of microgravity on the human body is a significant concern for space travelers. We report here initial results from a pilot study designed to explore the utility of artificial gravity (AG) as a countermeasure to the effects of microgravity, specifically to bone loss. After an initial phase of adaptation and testing, 15 male subjects underwent 21 days of 6 head-down bed rest to simulate the deconditioning associated with space flight. Eight of the subjects underwent 1 h of centrifugation (AG, 1 gz at the heart, 2.5 gz at the feet) each day for 21 days, while 7 of the subjects served as untreated controls (CN). Blood and urine were collected before, during, and after bed rest for bone marker determinations. At this point, preliminary data are available on the first 8 subjects (6 AG, and 2 CN). Comparing the last week of bed rest to before bed rest, urinary excretion of the bone resorption marker n-telopeptide increased 95 plus or minus 59% (mean plus or minus SD) in CN but only 32 plus or minus 26% in the AG group. Similar results were found for another resorption marker, helical peptide (increased 57 plus or minus 0% and 35 plus or minus 13% in CN and AG respectively). Bone-specific alkaline phosphatase, a bone formation marker, did not change during bed rest. At this point, sample analyses are continuing, including calcium tracer kinetic studies. These initial data demonstrate the potential effectiveness of short-radius, intermittent AG as a countermeasure to the bone deconditioning that occurs during bed rest.

  6. Synthetic Bone Substitute Engineered with Amniotic Epithelial Cells Enhances Bone Regeneration after Maxillary Sinus Augmentation

    PubMed Central

    Barboni, Barbara; Mangano, Carlo; Valbonetti, Luca; Marruchella, Giuseppe; Berardinelli, Paolo; Martelli, Alessandra; Muttini, Aurelio; Mauro, Annunziata; Bedini, Rossella; Turriani, Maura; Pecci, Raffaella; Nardinocchi, Delia; Zizzari, Vincenzo Luca; Tetè, Stefano; Piattelli, Adriano; Mattioli, Mauro

    2013-01-01

    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. Aim 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. Material And Methods Two blocks of synthetic bone substitute (∼0.14 cm3), alone or engineered with 1×106 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. Results And 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

  7. The Clinical Use of Allografts, Demineralized Bone Matrices, Synthetic Bone Graft Substitutes and Osteoinductive Growth Factors: A Survey Study

    PubMed Central

    Seigerman, Daniel A.

    2005-01-01

    The emergence of new bone grafting options and alternatives has led to significant uncertainty when determining the most appropriate product for surgical procedures requiring bone graft in orthopedics. Allografts, demineralized bone matrices, synthetic bone graft substitutes, and osteoinductive growth factors are all viable options, yet there is a lack of data reporting clinical usage of these products. This correspondence reports on the use of bone grafting products at the Hospital for Special Surgery for a 27-month period and makes recommendations based on surgical usage, safety, and cost. Approximately half (48.6%) of all bone graft substitutes were implanted during spinal surgery. Arthroplasty, trauma, and foot/hand cases all used considerable amounts of bone grafting products as well (20.1%, 19.0%, 12.1%, respectively). Considerable differences were noticed in usage of bone grafting products among each orthopedic discipline. Of all bone graft substitutes used in arthroplasty, 14.4% were demineralized bone matrices, whereas 56.8% were allografts. Demineralized bone matrix grafts were used in 82% of trauma surgery and 89% of foot/hand cases. An increase in synthetic bone graft alternatives was noticed near the end of our investigation period. PMID:18751803

  8. Osteointegration of porous absorbable bone substitutes: A systematic review of the literature.

    PubMed

    Paulo, Maria Júlia Escanhoela; Dos Santos, Mariana Avelino; Cimatti, Bruno; Gava, Nelson Fabrício; Riberto, Marcelo; Engel, Edgard Eduard

    2017-07-01

    Biomaterials' structural characteristics and the addition of osteoinductors influence the osteointegration capacity of bone substitutes. This study aims to identify the characteristics of porous and resorbable bone substitutes that influence new bone formation. An Internet search for studies reporting new bone formation rates in bone defects filled with porous and resorbable substitutes was performed in duplicate using the PubMed, Web of Science, Scielo, and University of São Paulo Digital Library databases. Metaphyseal or calvarial bone defects 4 to 10 mm in diameter from various animal models were selected. New bone formation rates were collected from the histomorphometry or micro-CT data. The following variables were analyzed: animal model, bone region, defect diameter, follow-up time after implantation, basic substitute material, osteoinductor addition, pore size and porosity. Of 3,266 initially identified articles, 15 articles describing 32 experimental groups met the inclusion criteria. There were no differences between the groups in the experimental model characteristics, except for the follow-up time, which showed a very weak to moderate correlation with the rate of new bone formation. In terms of the biomaterial and structural characteristics, only porosity showed a significant influence on the rate of new bone formation. Higher porosity is related to higher new bone formation rates. The influence of other characteristics could not be identified, possibly due to the large variety of experimental models and methodologies used to estimate new bone formation rates. We suggest the inclusion of standard control groups in future experimental studies to compare biomaterials.

  9. Alveolar bone regeneration for immediate implant placement using an injectable bone substitute: an experimental study in dogs

    PubMed Central

    Boix, Damien; Gauthier, Olivier; Guicheux, Jérôme; Pilet, Paul; Weiss, Pierre; Grimandi, Gaël; Daculsi, Guy

    2004-01-01

    Background The aim of the present study was to assess the efficacy of a ready-to-use injectable bone substitute for bone regeneration around dental implants placed into fresh extraction sockets. Methods Third and fourth mandibular premolars were extracted from 3 Beagle dogs and the interradicular septa were surgically reduced to induce a mesial bone defect. Thereafter, immediate placements of titanium implants were performed. On the left side of the jaw, mesial bone defects were filled with an injectable bone substitute (IBS), obtained by combining a polymer and a biphasic calcium phosphate ceramic. As a control, the right defects were left unfilled. After 3 months of healing, specimens were prepared for histological and histomorphometric evaluations. Results No post surgical complication was observed during the healing period. In all experimental conditions, histological observations revealed a lamellar bone formation in contact with the implant. Histomorphometric analysis showed that IBS triggers a significant (p<0.05) increase in term of thread numbers in contact with bone (TN), bone-to-implant contact (BIC) and peri-implant bone density (PBD), of about 8.6%, 11.0% and 14.7%, respectively. In addition, no significant difference was observed when TN, BIC and PBD in filled defects were compared to no-defect sites. Conclusion It is concluded that an injectable bone substitute composed of a polymeric carrier and calcium phosphate significantly increase bone regeneration around immediate implants. PMID:15212348

  10. The revision acetabulum--allograft and bone substitutes: vestigial organs for bone deficiency.

    PubMed

    Callaghan, J J; Liu, S S; Phruetthiphat, O-A

    2014-11-01

    A common situation presenting to the orthopaedic surgeon today is a worn acetabular liner with substantial acetabular and pelvic osteolysis. The surgeon has many options for dealing with osteolytic defects. These include allograft, calcium based substitutes, demineralised bone matrix, or combinations of these options with or without addition of platelet rich plasma. To date there are no clinical studies to determine the efficacy of using bone-stimulating materials in osteolytic defects at the time of revision surgery and there are surprisingly few studies demonstrating the clinical efficacy of these treatment options. Even when radiographs appear to demonstrate incorporation of graft material CT studies have shown that incorporation is incomplete. The surgeon, in choosing a graft material for a surgical procedure must take into account the efficacy, safety, cost and convenience of that material.

  11. Novel bone substitute material in alveolar bone healing following tooth extraction: an experimental study in sheep.

    PubMed

    Liu, Jinyi; Schmidlin, Patrick R; Philipp, Alexander; Hild, Nora; Tawse-Smith, Andrew; Duncan, Warwick

    2016-07-01

    Electrospun cotton wool-like nanocomposite (ECWN) is a novel synthetic bone substitute that incorporates amorphous calcium phosphate nanoparticles into a biodegradable synthetic copolymer poly(lactide-co-glycolide). The objectives of this study were to develop a tooth extraction socket model in sheep for bone graft research and to compare ECWN and bovine-derived xenograft (BX) in this model. Sixteen cross-bred female sheep were used. Bilateral mandibular premolars were extracted atraumatically. Second and third premolar sockets were filled (Latin-square allocation) with BX, ECWN or left unfilled. Resorbable collagen membranes were placed over BX and selected ECWN grafted sockets. Eight sheep per time period were sacrificed after 8 and 16 weeks. Resin-embedded undemineralised sections were analysed for descriptive histology and histomorphometric analyses. At 8 weeks, there were with no distinct differences in healing among the different sites. At 16 weeks, osseous healing followed a fine trabecular pattern in ECWN sites. Non-grafted sites showed thick trabeculae separated by large areas of fibrovascular connective tissue. In BX grafted sites, xenograft particles were surrounded by newly formed bone or fibrovascular connective tissue. There were no statistically significant differences in bone formation across the four groups. However, ECWN sites had significantly less residual graft material than BX sites at 16 weeks (P = 0.048). This first description of a tooth extraction socket model in sheep supports the utility of this model for bone graft research. The results of this study suggested that the novel material ECWN did not impede bone ingrowth into sockets and showed evidence of material resorption. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. [The construction of two kinds of artificial bone and the comparison of their osteogenesis capability in vivo].

    PubMed

    Zhang, Qi-qing; Zhang, Li-hai; Liu, Ling-rong; Liang, Yi; Ren, Bai-zhi; Wang, Fu-jun

    2003-02-01

    To construct artificial bone with collagen-hydroxyapatite (HA) or collagen-HA-chondroitin sulfate (CS) as the scaffolds, and observe their biological properties. The artificial bones were constructed by attaching recombinant human bone morphogenetic protein 2 (rhBMP-2) on those scaffolds. And then they were embedded into muscles of rats. Every weekend those newly formed bones were taken from muscles for comparing the difference in osteogenetic capability of two kinds of artificial bone in vivo. Both kinds of artificial bones could induce bone regeneration in muscle. The collagen-HA-CS artificial bone was superior to the collagen-HA artificial in bone-guided degree. The CS could promote the form action of new bone and accelerate the bone healing.

  13. The effect of particle size on the osteointegration of injectable silicate-substituted calcium phosphate bone substitute materials

    PubMed Central

    Coathup, Melanie J; Cai, Qian; Campion, Charlie; Buckland, Thomas; Blunn, Gordon W

    2013-01-01

    Calcium phosphate (CaP) particles as a carrier in an injectable bone filler allows less invasive treatment of bony defects. The effect of changing granule size within a poloxamer filler on the osteointegration of silicate-substituted calcium phosphate (SiCaP) bone substitute materials was investigated in an ovine critical-sized femoral condyle defect model. Treatment group (TG) 1 consisted of SiCaP granules sized 1000–2000 μm in diameter (100 vol %). TG2 investigated a granule size of 250–500 μm (75 vol %), TG3 a granule size of 90–125 μm (75 vol %) and TG4 a granule size of 90–125 μm (50 vol %). Following a 4 and 8 week in vivo period, bone area, bone-implant contact, and remaining implant area were quantified within each defect. At 4 weeks, significantly increased bone formation was measured in TG2 (13.32% ± 1.38%) when compared with all other groups (p = 0.021 in all cases). Bone in contact with the bone substitute surface was also significantly higher in TG2. At 8 weeks most new bone was associated within defects containing the smallest granule size investigated (at the lower volume) (TG4) (42.78 ± 3.36%) however this group was also associated with higher amounts of fragmented SiCaP. These smaller particles were phagocytosed by macrophages and did not appear to have a negative influence on healing. In conclusion, SiCaP granules of 250–500 μm in size may be a more suitable scaffold when used as an injectable bone filler and may be a convenient method for treating bony defects. © 2013 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials Published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 101B: 902–910, 2013 PMID:23362131

  14. The effect of particle size on the osteointegration of injectable silicate-substituted calcium phosphate bone substitute materials.

    PubMed

    Coathup, Melanie J; Cai, Qian; Campion, Charlie; Buckland, Thomas; Blunn, Gordon W

    2013-08-01

    Calcium phosphate (CaP) particles as a carrier in an injectable bone filler allows less invasive treatment of bony defects. The effect of changing granule size within a poloxamer filler on the osteointegration of silicate-substituted calcium phosphate (SiCaP) bone substitute materials was investigated in an ovine critical-sized femoral condyle defect model. Treatment group (TG) 1 consisted of SiCaP granules sized 1000-2000 μm in diameter (100 vol %). TG2 investigated a granule size of 250-500 μm (75 vol %), TG3 a granule size of 90-125 μm (75 vol %) and TG4 a granule size of 90-125 μm (50 vol %). Following a 4 and 8 week in vivo period, bone area, bone-implant contact, and remaining implant area were quantified within each defect. At 4 weeks, significantly increased bone formation was measured in TG2 (13.32% ± 1.38%) when compared with all other groups (p = 0.021 in all cases). Bone in contact with the bone substitute surface was also significantly higher in TG2. At 8 weeks most new bone was associated within defects containing the smallest granule size investigated (at the lower volume) (TG4) (42.78 ± 3.36%) however this group was also associated with higher amounts of fragmented SiCaP. These smaller particles were phagocytosed by macrophages and did not appear to have a negative influence on healing. In conclusion, SiCaP granules of 250-500 μm in size may be a more suitable scaffold when used as an injectable bone filler and may be a convenient method for treating bony defects. Copyright © 2013 Wiley Periodicals, Inc.

  15. Organoapatites: materials for artificial bone. II. Hardening reactions and properties.

    PubMed

    Stupp, S I; Mejicano, G C; Hanson, J A

    1993-03-01

    This article reports on chemical reactions and the properties they generated in artificial bone materials termed "organoapatites." These materials are synthesized using methodology we reported in the previous article of this series. Two different processes were studied here for the transition from organoapatite particles to implants suitable for the restoration of the skeletal system. One process involved the hardening of powder compacts by beams of blue light derived from a lamp or a laser and the other involved pressure-induced interdiffusion of polymers. In both cases, the hardening reaction involved the formation of a polyion complex between two polyelectrolytes. In the photo-induced reaction an anionic electrolyte polymerizes to form the coulombic network and in the pressure-induced one, pressure forms the complex by interdiffusion of two polyions. Model reactions were studied using various polycations. Based on these results the organoapatite selected for the study was that containing dispersed poly(L-lysine) and sodium acrylate as the anionic monomer. The organomineral particles can be pressed at room temperature into objects of great physical integrity and hydrolytic stability relative to anorganic controls. The remarkable fact about these objects is that intimate molecular dispersion of only 2-3% by weight organic material provides integrity to the mineral network in an aqueous medium and also doubles its tensile strength. This integrity is essentially nonexistent in "anorganic" samples prepared by the same methodology used in organoapatite synthesis. The improvement in properties was most effectively produced by molecular bridges formed by photopolymerization. The photopolymerization leads to the "hardening" of pellets prepared by pressing of organoapatite powders. The reaction was found to be more facile in the microstructure of the organomineral, and it is potentially useful in the surgical application of organoapatites as artificial bone.

  16. [Biomechanical consideration regarding bone substitutes use in surgical treatment of chronic osteomyelitis].

    PubMed

    Damir, Daniela; Munteanu, Fl

    2010-01-01

    The main aim of this study is to present the use of bone substitutes in chronic ostheomielitis surgical treatment and its biomechanical influence. First step is three-dimensional reconstruction to one femur using CT sections; the second is the reconstruction of infected bone volume, synthesis of material properties, synthesis of loading forces, synthesis of boundary condition and, finally, finite element analysis. The calculated Von Mises stress as a result of finite element analysis indicates that bone substitute implantation lead to a stress distribution in bone similar with a health femur.

  17. Eggshell Derived Hydroxyapatite as Bone Graft Substitute in the Healing of Maxillary Cystic Bone Defects: A Preliminary Report

    PubMed Central

    Kattimani, Vivekanand S; Chakravarthi, P Srinivas; Kanumuru, Narasimha Reddy; Subbarao, Vummidisetti V; Sidharthan, A; Kumar, T S Sampath; Prasad, L Krishna

    2014-01-01

    Background: Since ancient times, use of graft materials to promote healing of defects of bone is wellknown. Traditionally, missing bone is replaced with material from either patient or donor. Multiple sources of bone grafts have been used to graft bone defects to stimulate bone healing. Hydroxyapatite is naturally occurring mineral component of bone, which is osteoconductive. This versatile biomaterial is derived from many sources. The aim of this study is to evaluate the efficacy of eggshell derived hydroxyapatite (EHA) in the bone regeneration of human maxillary cystic bone defects secondary to cystic removal/apicoectomy and compare the material properties of EHA in vitro. Materials and Methods: A total of eight maxillary bone defects were grafted after cystic enucleation and/or apicoectomy in the year 2008 and completed the study at 1 year. The patients were followed-up 2 weeks after surgery for signs and symptoms of infection or any other complications that may have been related to surgical procedure. Follow-up radiographs were obtained immediately after surgery followed by 1, 2, and 3 months to assess the efficacy of EHA in bone healing. Physicochemical characterization of the EHA was carried out in comparison with synthetic hydroxyapatite (SHA), also compared the biocompatibility of EHA using in vitro cytotoxicity test. Results: By the end of the 8th week, the defects grafted with EHA showed complete bone formation. However, bone formation in non-grafted sites was insignificant. The values of density measurements were equal or more than that of surrounding normal bone. These results indicate that the osseous regeneration of the bone defect filled with EHA is significant. EHA showed the superior material properties in comparison with SHA. Conclusion: EHA is a versatile novel bone graft substitute that yielded promising results. Because of its biocompatibility, lack of disease transfer risks, ease of use and unlimited availability, EHA remains a viable choice

  18. Current trends and future perspectives of bone substitute materials - from space holders to innovative biomaterials.

    PubMed

    Kolk, Andreas; Handschel, Jörg; Drescher, Wolf; Rothamel, Daniel; Kloss, Frank; Blessmann, Marco; Heiland, Max; Wolff, Klaus-Dietrich; Smeets, Ralf

    2012-12-01

    An autologous bone graft is still the ideal material for the repair of craniofacial defects, but its availability is limited and harvesting can be associated with complications. Bone replacement materials as an alternative have a long history of success. With increasing technological advances the spectrum of grafting materials has broadened to allografts, xenografts, and synthetic materials, providing material specific advantages. A large number of bone-graft substitutes are available including allograft bone preparations such as demineralized bone matrix and calcium-based materials. More and more replacement materials consist of one or more components: an osteoconductive matrix, which supports the ingrowth of new bone; and osteoinductive proteins, which sustain mitogenesis of undifferentiated cells; and osteogenic cells (osteoblasts or osteoblast precursors), which are capable of forming bone in the proper environment. All substitutes can either replace autologous bone or expand an existing amount of autologous bone graft. Because an understanding of the properties of each material enables individual treatment concepts this review presents an overview of the principles of bone replacement, the types of graft materials available, and considers future perspectives. Bone substitutes are undergoing a change from a simple replacement material to an individually created composite biomaterial with osteoinductive properties to enable enhanced defect bridging. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  19. Geometric analysis of porous bone substitutes using micro-computed tomography and fuzzy distance transform.

    PubMed

    Bashoor-Zadeh, M; Baroud, G; Bohner, M

    2010-03-01

    There is increased interest in resorbable bone substitutes for skeletal reconstruction. Important geometric design measures of bone substitute include pore size, interconnection size, porosity, permeability and surface area of the substitute. In this study, four substitute groups with variable geometric features but constant porosity were scanned using micro-computed tomography (microCT) and their geometric measures were determined using an advanced image-processing algorithm based on fuzzy distance transform and new pore size definition. The substitutes were produced using the calcium phosphate emulsion method. The geometric analysis revealed that the reproducibility of the emulsion method was high, within 5%. The average porosity of the four groups was 52.3 + or - 1.5. The pore diameter of the four bone substitute groups was measured to be 170 + or - 1.7, 217 + or - 5.2, 416 + or - 19, and 972 + or - 11 microm. Despite this significant change in pore size, the interconnection size only increased slightly with an increase of pore size. The specific surface decreased with increasing pore size. The permeability increased with the pore size and was inversely proportional to the specific surface. The combination of microCT and the fuzzy image-processing tool enables accurate geometric analysis, even if pore size and image resolution are in the same range, such as in the case of the smallest pore size. Moreover, it is an exciting tool to understand the structure of the substitute with the hope of designing better bone substitutes.

  20. Clinical Application of Antimicrobial Bone Graft Substitute in Osteomyelitis Treatment: A Systematic Review of Different Bone Graft Substitutes Available in Clinical Treatment of Osteomyelitis.

    PubMed

    van Vugt, T A G; Geurts, J; Arts, J J

    2016-01-01

    Osteomyelitis is a common occurrence in orthopaedic surgery, which is caused by different bacteria. Treatment of osteomyelitis patients aims to eradicate infection by debridement surgery and local and systemic antibiotic therapy. Local treatment increases success rates and can be performed with different antimicrobial bone graft substitutes. This review is performed to assess the level of evidence of synthetic bone graft substitutes in osteomyelitis treatment. According to the PRISMA statement for reporting systematic reviews, different types of clinical studies concerning treatment of osteomyelitis with bone graft substitutes are included. These studies are assessed on their methodological quality as level of evidence and bias and their clinical outcomes as eradication of infection. In the fifteen included studies, the levels of evidence were weak and in ten out of the fifteen studies there was a moderate to high risk of bias. However, first results of the eradication of infection in these studies showed promising results with their relatively high success rates and low complication rates. Due to the low levels of evidence and high risks of bias of the included studies, these results are inconclusive and no conclusions regarding the performed clinical studies of osteomyelitis treatment with antimicrobial bone graft substitutes can be drawn.

  1. Fabrication and development of artificial osteochondral constructs based on cancellous bone/hydrogel hybrid scaffold.

    PubMed

    Song, Kedong; Li, Liying; Yan, Xinyu; Zhang, Yu; Li, Ruipeng; Wang, Yiwei; Wang, Ling; Wang, Hong; Liu, Tianqing

    2016-06-01

    Using tissue engineering techniques, an artificial osteochondral construct was successfully fabricated to treat large osteochondral defects. In this study, porcine cancellous bones and chitosan/gelatin hydrogel scaffolds were used as substitutes to mimic bone and cartilage, respectively. The porosity and distribution of pore size in porcine bone was measured and the degradation ratio and swelling ratio for chitosan/gelatin hydrogel scaffolds was also determined in vitro. Surface morphology was analyzed with the scanning electron microscope (SEM). The physicochemical properties and the composition were tested by using an infrared instrument. A double layer composite scaffold was constructed via seeding adipose-derived stem cells (ADSCs) induced to chondrocytes and osteoblasts, followed by inoculation in cancellous bones and hydrogel scaffolds. Cell proliferation was assessed through Dead/Live staining and cellular activity was analyzed with IpWin5 software. Cell growth, adhesion and formation of extracellular matrix in composite scaffolds blank cancellous bones or hydrogel scaffolds were also analyzed. SEM analysis revealed a super porous internal structure of cancellous bone scaffolds and pore size was measured at an average of 410 ± 59 μm while porosity was recorded at 70.6 ± 1.7 %. In the hydrogel scaffold, the average pore size was measured at 117 ± 21 μm and the porosity and swelling rate were recorded at 83.4 ± 0.8 % and 362.0 ± 2.4 %, respectively. Furthermore, the remaining hydrogel weighed 80.76 ± 1.6 % of the original dry weight after hydration in PBS for 6 weeks. In summary, the cancellous bone and hydrogel composite scaffold is a promising biomaterial which shows an essential physical performance and strength with excellent osteochondral tissue interaction in situ. ADSCs are a suitable cell source for osteochondral composite reconstruction. Moreover, the bi-layered scaffold significantly enhanced cell proliferation compared to the cells seeded on

  2. Osteointegration of porous absorbable bone substitutes: A systematic review of the literature

    PubMed Central

    Paulo, Maria Júlia Escanhoela; dos Santos, Mariana Avelino; Cimatti, Bruno; Gava, Nelson Fabrício; Riberto, Marcelo; Engel, Edgard Eduard

    2017-01-01

    Biomaterials’ structural characteristics and the addition of osteoinductors influence the osteointegration capacity of bone substitutes. This study aims to identify the characteristics of porous and resorbable bone substitutes that influence new bone formation. An Internet search for studies reporting new bone formation rates in bone defects filled with porous and resorbable substitutes was performed in duplicate using the PubMed, Web of Science, Scielo, and University of São Paulo Digital Library databases. Metaphyseal or calvarial bone defects 4 to 10 mm in diameter from various animal models were selected. New bone formation rates were collected from the histomorphometry or micro-CT data. The following variables were analyzed: animal model, bone region, defect diameter, follow-up time after implantation, basic substitute material, osteoinductor addition, pore size and porosity. Of 3,266 initially identified articles, 15 articles describing 32 experimental groups met the inclusion criteria. There were no differences between the groups in the experimental model characteristics, except for the follow-up time, which showed a very weak to moderate correlation with the rate of new bone formation. In terms of the biomaterial and structural characteristics, only porosity showed a significant influence on the rate of new bone formation. Higher porosity is related to higher new bone formation rates. The influence of other characteristics could not be identified, possibly due to the large variety of experimental models and methodologies used to estimate new bone formation rates. We suggest the inclusion of standard control groups in future experimental studies to compare biomaterials. PMID:28793006

  3. Histological Features and Biocompatibility of Bone and Soft Tissue Substitutes in the Atrophic Alveolar Ridge Reconstruction

    PubMed Central

    Rancitelli, Davide; Grossi, Giovanni Battista; Herford, Alan Scott

    2016-01-01

    The reconstruction of the atrophic alveolar ridges for implant placement is today a common procedure in dentistry daily practice. The surgical reconstruction provides for the optimization of the supporting bone for the implants and a restoration of the amount of keratinized gingiva for esthetic and functional reasons. In the past, tissue regeneration has been performed with autogenous bone and free gingival or connective tissue grafts. Nowadays, bone substitutes and specific collagen matrix allow for a complete restoration of the atrophic ridge without invasive harvesting procedures. A maxillary reconstruction of an atrophic ridge by means of tissue substitutes and its histological features are then presented. PMID:27022489

  4. Osseointegration of Titanium Implants in Onlay of Cerament™, a New Ceramic Bone Substitute

    PubMed Central

    Truedsson, Anna; Wang, Jian-Sheng; Lindberg, Pia; Warfvinge, Gunnar

    2016-01-01

    The purpose was to investigate whether a new biphasic and injectable ceramic bone substitute Cerament™ that rapidly remodels to bone, may contribute to the retention of titanium implant screws during the healing period, and to analyze the pattern of bone formation around titanium implants.Titanium screws were implanted in rat tibiae and embedded with or without Cerament™ on the cortical surface. Torsional resistance was measured after 1 day, and after 6 and 12 weeks. Implant areas without bone substitute were analyzed histologically for comparison. The torsional resistance increased over time as the screws were osseointegrated. There was no difference in resistance between screws embedded in the bone substitute and control screws. The bone apposition was more pronounced on the proximal side of the screw than on the distal side. Cerament™ is capable of conducting bone growth from a cortical bone surface. The newly formed bone in this application does not significantly add to the osseointegrative strength of the implant screw, as measured by torque resistance, during the first 12 weeks. PMID:26751485

  5. Bone substitutes and expanders in Spine Surgery: A review of their fusion efficacies

    PubMed Central

    Millhouse, Paul W; Kepler, Christopher K; Radcliff, Kris E.; Fehlings, Michael G.; Janssen, Michael E.; Sasso, Rick C.; Benedict, James J.; Vaccaro, Alexander R

    2016-01-01

    Study Design A narrative review of literature. Objective This manuscript intends to provide a review of clinically relevant bone substitutes and bone expanders for spinal surgery in terms of efficacy and associated clinical outcomes, as reported in contemporary spine literature. Summary of Background Data Ever since the introduction of allograft as a substitute for autologous bone in spinal surgery, a sea of literature has surfaced, evaluating both established and newly emerging fusion alternatives. An understanding of the available fusion options and an organized evidence-based approach to their use in spine surgery is essential for achieving optimal results. Methods A Medline search of English language literature published through March 2016 discussing bone graft substitutes and fusion extenders was performed. All clinical studies reporting radiological and/or patient outcomes following the use of bone substitutes were reviewed under the broad categories of Allografts, Demineralized Bone Matrices (DBM), Ceramics, Bone Morphogenic proteins (BMPs), Autologous growth factors (AGFs), Stem cell products and Synthetic Peptides. These were further grouped depending on their application in lumbar and cervical spine surgeries, deformity correction or other miscellaneous procedures viz. trauma, infection or tumors; wherever data was forthcoming. Studies in animal populations and experimental in vitro studies were excluded. Primary endpoints were radiological fusion rates and successful clinical outcomes. Results A total of 181 clinical studies were found suitable to be included in the review. More than a third of the published articles (62 studies, 34.25%) focused on BMP. Ceramics (40 studies) and Allografts (39 studies) were the other two highly published groups of bone substitutes. Highest radiographic fusion rates were observed with BMPs, followed by allograft and DBM. There were no significant differences in the reported clinical outcomes across all classes of bone

  6. Traumatic Periprosthetic Acetabular Fracture Treated with One-Stage Exchange and Bone Reconstruction Using a Synthetic Bone Graft Substitute.

    PubMed

    Svacina, Jan

    2016-01-01

    A case of a traumatic periprosthetic acetabular fracture in an elderly patient, which was treated by one-stage hip exchange with implantation of an antiprotrusio cage and reconstruction of the acetabular bone loss with an injectable calcium sulphate/hydroxyapatite bone graft substitute, is reported. The paste-like bone graft substitute was injected through the holes of the antiprotrusio cage. After a setting time of 15 minutes, a low-profile cup was cemented onto the cage using polymethylmethacrylate and a new stem was inserted. The patient was encouraged to ambulate three days postoperatively weight-bearing as tolerated. At the one-year follow-up visit the patient was ambulatory and full weight-bearing without any walking aids. The follow-up radiographs demonstrated stable position and articulation of the revision hip arthroplasty with no signs of loosening of the antiprotrusio cage. However, the most interesting finding was that the bone graft substitute had remodelled to a great extent into bone. This calcium sulphate/hydroxyapatite composite shows high osteoconductive potential and can be used to regenerate bone stock in revision arthroplasty.

  7. Traumatic Periprosthetic Acetabular Fracture Treated with One-Stage Exchange and Bone Reconstruction Using a Synthetic Bone Graft Substitute

    PubMed Central

    2016-01-01

    A case of a traumatic periprosthetic acetabular fracture in an elderly patient, which was treated by one-stage hip exchange with implantation of an antiprotrusio cage and reconstruction of the acetabular bone loss with an injectable calcium sulphate/hydroxyapatite bone graft substitute, is reported. The paste-like bone graft substitute was injected through the holes of the antiprotrusio cage. After a setting time of 15 minutes, a low-profile cup was cemented onto the cage using polymethylmethacrylate and a new stem was inserted. The patient was encouraged to ambulate three days postoperatively weight-bearing as tolerated. At the one-year follow-up visit the patient was ambulatory and full weight-bearing without any walking aids. The follow-up radiographs demonstrated stable position and articulation of the revision hip arthroplasty with no signs of loosening of the antiprotrusio cage. However, the most interesting finding was that the bone graft substitute had remodelled to a great extent into bone. This calcium sulphate/hydroxyapatite composite shows high osteoconductive potential and can be used to regenerate bone stock in revision arthroplasty. PMID:27446621

  8. Bone Substitutes for Peri-Implant Defects of Postextraction Implants

    PubMed Central

    Santos, Pâmela Letícia; Gulinelli, Jéssica Lemos; Telles, Cristino da Silva; Betoni Júnior, Walter; Chiacchio Buchignani, Vivian; Queiroz, Thallita Pereira

    2013-01-01

    Placement of implants in fresh sockets is an alternative to try to reduce physiological resorption of alveolar ridge after tooth extraction. This surgery can be used to preserve the bone architecture and also accelerate the restorative procedure. However, the diastasis observed between bone and implant may influence osseointegration. So, autogenous bone graft and/or biomaterials have been used to fill this gap. Considering the importance of bone repair for treatment with implants placed immediately after tooth extraction, this study aimed to present a literature review about biomaterials surrounding immediate dental implants. The search included 56 articles published from 1969 to 2012. The results were based on data analysis and discussion. It was observed that implant fixation immediately after extraction is a reliable alternative to reduce the treatment length of prosthetic restoration. In general, the biomaterial should be used to increase bone/implant contact and enhance osseointegration. PMID:24454377

  9. World's First Clinical Case of Gene-Activated Bone Substitute Application

    PubMed Central

    Deev, R. V.; Drobyshev, A. Y.; Isaev, A. A.; Eremin, I. I.

    2016-01-01

    Treatment of patients with large bone defects is a complex clinical problem. We have initiated the first clinical study of a gene-activated bone substitute composed of the collagen-hydroxyapatite scaffold and plasmid DNA encoding vascular endothelial growth factor. The first patient with two nonunions of previously reconstructed mandible was enrolled into the study. Scar tissues were excised; bone defects (5–14 mm) between the mandibular fragments and nonvascularized rib-bone autograft were filled in with the gene-activated bone substitute. No adverse events were observed during 12 months of follow-up. In 3 months, the average density of newly formed tissues within the implantation zone was 402.21 ± 84.40 and 447.68 ± 106.75 HU in the frontal and distal regions, respectively, which correlated with the density of spongy bone. Complete distal bone defect repair with vestibular and lingual cortical plates formation was observed in 6 and 12 months after surgery; thereby the posterior nonunion was successfully eliminated. However, there was partial resorption of the proximal edge of the autograft entailed to relapse of the anterior nonunion. Thus, the first clinical data on the safety and efficacy of the gene-activated bone substitute were obtained. Given a high complexity of the clinical situation the treatment, results might be considered as promising. NCT02293031. PMID:27891264

  10. Nacre, a natural, multi-use, and timely biomaterial for bone graft substitution.

    PubMed

    Zhang, Ganggang; Brion, Alice; Willemin, Anne-Sophie; Piet, Marie-Hélène; Moby, Vanessa; Bianchi, Arnaud; Mainard, Didier; Galois, Laurent; Gillet, Pierre; Rousseau, Marthe

    2017-02-01

    During the past two decades, with a huge and rapidly increasing clinical need for bone regeneration and repair, bone substitutes are more and more seen as a potential solution. Major innovation efforts are being made to develop such substitutes, some having advanced even to clinical practice. It is now time to turn to natural biomaterials. Nacre, or mother-of-pearl, is an organic matrix-calcium carbonate coupled shell structure produced by molluscs. In vivo and in vitro studies have revealed that nacre is osteoinductive, osteoconductive, biocompatible, and biodegradable. With many other outstanding qualities, nacre represents a natural and multi-use biomaterial as a bone graft substitute. This review aims at summarising the current needs in orthopaedic clinics and the challenges for the development of bone substitutes; most of all, we systematically review the physiological characteristics and biological evidence of nacre's effects centred on osteogenesis, and finally we put forward the potential use of nacre as a bone graft substitute. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 662-671, 2017.

  11. Preparation, degradation, and calcification of biodegradable polyurethane foams for bone graft substitutes.

    PubMed

    Gorna, Katarzyna; Gogolewski, Sylwester

    2003-12-01

    Autogenous cancellous bone graft is used to heal critical-size segmental long bone defects and defects in the maxillofacial skeleton. Harvesting of bone graft is traumatic, causes morbidity of the donor site, and often results in complications. Thus, there is a need for new biologically functional bone graft substitutes that, instead of autogenous bone graft, could be used to facilitate bone regeneration in critical-size defects. Porous biodegradable elastomeric polyurethane scaffolds combined with the patient's own bone marrow could potentially be such bone substitutes. The elastomeric bone substitute prevents shear forces at the interface between bone and rigid, e.g., ceramic bone substitutes and establishes an intimate contact with the native bone ends, thus facilitating the proliferation of osteogenic cells and bone regeneration. Crosslinked 3D biodegradable polyurethane scaffolds (foams) with controlled hydrophilicity for bone graft substitutes were synthesized from biocompatible reactants. The scaffolds had hydrophilic-to-hydrophobic content ratios of 70:30, 50:50, and 30:70. The reactants used were hexamethylene diisocyanate, poly(ethylene oxide) diol (MW = 600) (hydrophilic component), and poly(epsilon-caprolactone) diol (M(w) = 2000), amine-based polyol (M(w) = 515) or sucrose-based polyol (M(w) = 445) (hydrophobic component), water as the chain extender and foaming agent, and stannous octoate, dibutyltin dilaurate, ferric acetylacetonate, and zinc octoate as catalysts. Citric acid was used as a calcium complexing agent, calcium carbonate, glycerol phosphate calcium salt, and hydroxyapatite were used as inorganic fillers, and lecithin or solutions of vitamin D(3) were used as surfactants. The scaffolds had an open-pore structure with pores whose size and geometry depended on the material's chemical composition. The compressive strengths of the scaffolds were in the range of 4-340 kPa and the compressive moduli in the range of 9-1960 kPa, the values of

  12. Bone substitute material on the basis of natural components

    NASA Astrophysics Data System (ADS)

    Melnikova, S.; Zelichenko, E.; Zenin, B.; Guzeev, V.; Gurova, O.

    2014-10-01

    The creation of regenerative materials remains a problem for rehabilitation medicine, but the obtaining of initial substances that can cause bone tissue regeneration, possessing biological activity and creation on their basis of composite materials with specified physical and mechanical characteristics is an important scientific problem. This paper presents the investigation of physical-chemical and biological properties of bioresorbable composite material that can restore their own bone tissue of the body.

  13. A perfusion bioreactor system efficiently generates cell‐loaded bone substitute materials for addressing critical size bone defects

    PubMed Central

    Kleinhans, Claudia; Mohan, Ramkumar Ramani; Vacun, Gabriele; Schwarz, Thomas; Haller, Barbara; Sun, Yang; Kahlig, Alexander; Kluger, Petra; Finne‐Wistrand, Anna; Walles, Heike

    2015-01-01

    Abstract Critical size bone defects and non‐union fractions are still challenging to treat. Cell‐loaded bone substitutes have shown improved bone ingrowth and bone formation. However, a lack of methods for homogenously colonizing scaffolds limits the maximum volume of bone grafts. Additionally, therapy robustness is impaired by heterogeneous cell populations after graft generation. Our aim was to establish a technology for generating grafts with a size of 10.5 mm in diameter and 25 mm of height, and thus for grafts suited for treatment of critical size bone defects. Therefore, a novel tailor‐made bioreactor system was developed, allowing standardized flow conditions in a porous poly(L‐lactide‐co‐caprolactone) material. Scaffolds were seeded with primary human mesenchymal stem cells derived from four different donors. In contrast to static experimental conditions, homogenous cell distributions were accomplished under dynamic culture. Additionally, culture in the bioreactor system allowed the induction of osteogenic lineage commitment after one week of culture without addition of soluble factors. This was demonstrated by quantitative analysis of calcification and gene expression markers related to osteogenic lineage. In conclusion, the novel bioreactor technology allows efficient and standardized conditions for generating bone substitutes that are suitable for the treatment of critical size defects in humans. PMID:26011163

  14. [Treatment of lower limb osteomyelitis by a local bone substitute supplemented with antibiotics].

    PubMed

    Berner, A; Linde, H J; Schubert, T; Nerlich, M; Englert, C

    2008-01-01

    A seriously injured tsunami victim with complicated osteomyelitis is presented. The patient was treated with a new resorbable bone substitute, which can be loaded with different antibiotics. The successful treatment is illustrated by the clinical, radiological and histological features. Bilateral open fractures of the lower leg with open elbow fracture led to a bilateral amputation of the lower legs and the right arm because of a beginning sepsis. The following intramedullary osteitis with multiresistant Pseudomonas aeruginosa, Escherichia coli and Enterococcus faecium was treated with the bone substitute PerOssal combined with systemic and local application of vancomycin and systemic application of ceftazidime and meropenem. This case report illustrates the concept of an additional local antibiotic treatment of osteomyelitis by a bone substitute also functioning as a drug delivery system.

  15. Sr-substituted bone cements direct mesenchymal stem cells, osteoblasts and osteoclasts fate

    PubMed Central

    Panseri, Silvia; Dapporto, Massimiliano; Tampieri, Anna; Sprio, Simone

    2017-01-01

    Strontium-substituted apatitic bone cements enriched with sodium alginate were developed as a potential modulator of bone cells fate. The biological impact of the bone cement were investigated in vitro through the study of the effect of the nanostructured apatitic composition and the doping of strontium on mesenchymal stem cells, pre-osteoblasts and osteoclasts behaviours. Up to 14 days of culture the bone cells viability, proliferation, morphology and gene expression profiles were evaluated. The results showed that different concentrations of strontium were able to evoke a cell-specific response, in fact an inductive effect on mesenchymal stem cells differentiation and pre-osteoblasts proliferation and an inhibitory effect on osteoclasts activity were observed. Moreover, the apatitic structure of the cements provided a biomimetic environment suitable for bone cells growth. Therefore, the combination of biological features of this bone cement makes it as promising biomaterials for tissue regeneration. PMID:28196118

  16. Nanoparticles of cobalt-substituted hydroxyapatite in regeneration of mandibular osteoporotic bones

    PubMed Central

    Ignjatović, Nenad; Ajduković, Zorica; Savić, Vojin; Najman, Stevo; Mihailović, Dragan; Vasiljević, Perica; Stojanović, Zoran; Uskoković, Vuk; Uskoković, Dragan

    2012-01-01

    Indications exist that paramagnetic calcium phosphates may be able to promote regeneration of bone faster than their regular, diamagnetic counterparts. In this study, analyzed was the influence of paramagnetic cobalt-substituted hydroxyapatite nanoparticles on osteoporotic alveolar bone regeneration in rats. Simultaneously, biocompatibility of the material was tested in vitro, on osteoblastic MC3T3-E1 and epithelial Caco-2 cells in culture. The material was shown to be biocompatible and nontoxic when added to epithelial monolayers in vitro, while it caused a substantial decrease in the cell viability as well as deformation of the cytoskeleton and cell morphology when incubated with the osteoblastic cells. In the course of six months after the implantation of the material containing different amounts of cobalt, ranging from 5 – 12 wt%, in the osteoporotic alveolar bone of the lower jaw, the following parameters were investigated: histopathological parameters, alkaline phosphatase and alveolar bone density. The best result in terms of osteoporotic bone tissue regeneration was observed for hydroxyapatite nanoparticles with the largest content of cobalt ions. The histological analysis showed a high level of reparatory ability of the nanoparticulate material implanted in the bone defect, paralleled by a corresponding increase in the alveolar bone density. The combined effect of growth factors from autologous plasma admixed to cobalt-substituted hydroxyapatite was furthermore shown to have a crucial effect on the augmented osteoporotic bone regeneration upon the implantation of the biomaterial investigated in this study. PMID:23090835

  17. Hydroxyapatite-calcium sulfate-hyaluronic acid composite encapsulated with collagenase as bone substitute for alveolar bone regeneration.

    PubMed

    Subramaniam, Sadhasivam; Fang, Yen-Hsin; Sivasubramanian, Savitha; Lin, Feng-Huei; Lin, Chun-pin

    2016-01-01

    Periodontitis is a very severe inflammatory condition of the periodontium that progressively damages the soft tissue and destroys the alveolar bone that supports the teeth. The bone loss is naturally irreversible because of limited reparability of the teeth. Advancement in tissue engineering provides an effective regeneration of osseous defects with suitable dental implants or tissue-engineered constructs. This study reports a hydroxyapatite, calcium sulfate hemihydrate and hyaluronic acid laden collagenase (HAP/CS/HA-Col) as a bone substitute for the alveolar bone regeneration. The composite material was mechanically tested and the biocompatibility was evaluated by WST-1 assay. The in vivo bone formation was assessed in rat with alveolar bone defects and the bone augmentation by the HAP/CS/HA-Col composite was confirmed by micro-CT images and histological examination. The mechanical strength of 6.69 MPa with excellent biocompatibility was obtained for the HAP/CS/HA-Col composite. The collagenase release profile had facilitated the acceleration of bone remodeling process and it was confirmed by the findings of micro-CT and H&E staining. The bone defects implanted with HAP/CS/HA composite containing 2 mg/mL type I collagenase have shown improved new bone formation with matured bone morphology in comparison with the HAP/CS/HA composite that lacks the collagenase and the porous hydroxyapatite (p-HAP) granules. The said findings demonstrated that the collagenase inclusion in HAP/CS/HA composite is a feasible approach for the alveolar bone regeneration and the same design can also be applied to other defective tissues. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Mineralized polymer composites as biogenic bone substitute material

    NASA Astrophysics Data System (ADS)

    Shah, Rushita; Saha, Nabanita; Kitano, Takeshi; Saha, Petr

    2015-05-01

    Mineralized polymer composites (MPC) are recognized as potential fillers of bone defects. Though bioceramics exhibits quite a good bone-bonding and vascularization, it is considered to be too stiff and brittle for using alone. Thus, the use of polymer scaffold instead of bioceramics has several advantages including combining the osteoconductivity and bone-bonding potential of the inorganic phase with the porosity and interconnectivity of the three-dimensional construction. Aiming the advantages of ceramic-polymer composite scaffolds, the calcium carbonate (CaCO3) based biomineralized scaffold was prepared, where the PVP-CMC hydrogel was used as an extracellular matrix. This paper is reported about the morphology, swelling trend (in physiological solution) and viscoelastic behavior of (90 min mineralized) MPC. The dry MPC are off-white, coarse in texture, comparatively less flexible than the original PVP-CMC based hydrogel film, and the deposition of granular structures on the surface of the hydrogel film confirms about the development of biomineralized scaffold/polymer composites. Irrespective of thickness, the dry MPC shows higher values of swelling ratio within 30 min, which varies between 200-250 approximately. The dynamic viscoelastic nature of freshly prepared MPC was investigated applying 1% and 10% strain. At higher strain the viscoelastic moduli (G' and G") show significant change, and the nature of MPC turns from elastic to viscous. Based on the observed basic properties, the MPC (calcite based polymer composites) can be recommended for the treatment of adyanamic bone disorder.

  19. Deproteinated bovine bone vs. beta-tricalcium phosphate as bone graft substitutes: histomorphometric longitudinal study in the rabbit cranial vault.

    PubMed

    Martinez, Arturo; Balboa, Oscar; Gasamans, Iria; Otero-Cepeda, Xose Luis; Guitian, Francisco

    2015-06-01

    This article aims to study differences in the bone formation and the graft resorption of two bone graft substitutes (BGS). Besides, it is our attempt to observe possible qualitative and quantitative differences in the bone reparation of the outer layer covered by collagen membrane and the uncovered inner layer in close contact with dura mater. Twelve rabbits were employed. Deproteinized bovine bone (DBB) and β-tricalcium phosphate (BTCP) were used as BGS. Four subcritical round defects (7 mm) were drilled in the cranial vault, removing both cortical walls. One of the holes was filled with DBB, and other was filled with BTCP. Each symmetrical position to DBB and BTCP was left empty. The whole defect set was covered with a collagen membrane. Histological and morphometric analysis was performed for 1, 4, 8, 16, 32 and 52 weeks. Morphometry measurements were carried out taking into account the whole defect and splitting inner and outer areas. In DBB sites, a rapid bone growth is observed, linking the remaining particles and integrating them into the bone matrix. Permanence of these DBB particles from week 16 onwards restrains the growth of bone fraction. A greater bone growth appears in areas repaired with BTCP than in those repaired with DBB, both in the outer layer (under-membrane) and the inner layer (over dura mater). In DBB sites, a slower growth is observed in the inner layer, with no significant differences in the final bone fraction at both strata. Both materials favour the closure of the defects provoked. In both cases, a synergistic effect with the collagen membrane is observed. DBB remains integrated in the bone matrix, while BTCP displays a pattern of highly developed progressive resorption with an outstanding bone fraction development. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Anterior cervical discectomy and fusion using a porous hydroxyapatite bone graft substitute.

    PubMed

    Zdeblick, T A; Cooke, M E; Kunz, D N; Wilson, D; McCabe, R P

    1994-10-15

    This study analyzed the use of a coral hydroxyapatite bone substitute for use in ACDF both with and without an anterior cervical plate. The healing of multilevel anterior cervical fusions was tested using a goat model. Comparisons were drawn with histologic, radiographic, and biomechanical test data. Forty-nine mature alpine goats had three-level anterior discectomies performed. Seven treatment groups of seven goats each were used; Group I with no fusion, Group IIa having tricortical iliac crest autograft, Group IIb having autograft plus an anterior plate, Group IIIa having tricortical iliac crest fresh-frozen allograft, Group IIIb having allograft plus an anterior plate, Group IVa having rectangular-shaped implants of porous hydroxyapatite, and Group IVb having ProOsteon 500 implants with an anterior cervical plate. Histologically, at 12 weeks 48% of the ProOsteon (Interpore, Irvine, CA) implants were rated as incorporated, 10% as possessing a fibrous gap, 29% as collapsed, and 14% as extruded. Anterior cervical plating improved the results with 71% of the implants showing good incorporation, 24% with collapse, and 5% with a fibrous gap. These histologic results compare favorably with autogenous bone and are improved over allograft bone. Fluorochrome analysis showed that none of the implants had complete turnover with host bone, but that all possessed peripheral creeping substitution with cutting cones of new bone formation at 12 weeks. Biomechanically, the spines using the ProOsteon implant were less stiff in torsion than autograft, but equal in stiffness to allograft. Flexion-extension neutral zone stiffness was lower in the ProOsteon implant group than either allograft or autograft. The use of a coral-based hydroxyapatite bone graft substitute for anterior cervical fusions led to significant rates of implant collapse at 12 weeks but showed excellent biologic compatibility with good early creeping substitution of the implant by host bone. The concomitant use of

  1. Antimicrobial Formulations of Absorbable Bone Substitute Materials as Drug Carriers Based on Calcium Sulfate.

    PubMed

    Pförringer, D; Obermeier, A; Kiokekli, M; Büchner, H; Vogt, S; Stemberger, A; Burgkart, R; Lucke, M

    2016-07-01

    Substitution of bones is a well-established, necessary procedure to treat bone defects in trauma and orthopedic surgeries. For prevention or treatment of perioperative infection, the implantation of resorbable bone substitute materials carrying antibiotics is a necessary treatment. In this study, we investigated the newly formulated calcium-based resorbable bone substitute materials containing either gentamicin (CaSO4-G [Herafill-G]), vancomycin (CaSO4-V), or tobramycin (Osteoset). We characterized the released antibiotic concentration per unit. Bone substitute materials were implanted in bones of rabbits via a standardized surgical procedure. Clinical parameters and levels of the antibiotic-releasing materials in serum were determined. Local concentrations of antibiotics were measured using antimicrobial tests of bone tissue. Aminoglycoside release kinetics in vitro per square millimeter of bead surface showed the most prolonged release for gentamicin, followed by vancomycin and, with the fastest release, tobramycin. In vivo level in serum detected over 28 days was highest for gentamicin at 0.42 μg/ml, followed by vancomycin at 0.11 μg/ml and tobramycin at 0.04 μg/ml. The clinical parameters indicated high biocompatibility for materials used. None of the rabbits subjected to the procedure showed any adverse reaction. The highest availability of antibiotics at 14.8 μg/g on day 1 in the cortical tibia ex vivo was demonstrated for gentamicin, decreasing within 14 days. In the medulla, vancomycin showed a high level at 444 μg/g on day 1, decreasing continuously over 14 days, whereas gentamicin decreased faster within the initial 3 days. The compared antibiotic formulations varied significantly in release kinetics in serum as well as locally in medulla and cortex. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  2. Antimicrobial Formulations of Absorbable Bone Substitute Materials as Drug Carriers Based on Calcium Sulfate

    PubMed Central

    Obermeier, A.; Kiokekli, M.; Büchner, H.; Vogt, S.; Stemberger, A.; Burgkart, R.; Lucke, M.

    2016-01-01

    Substitution of bones is a well-established, necessary procedure to treat bone defects in trauma and orthopedic surgeries. For prevention or treatment of perioperative infection, the implantation of resorbable bone substitute materials carrying antibiotics is a necessary treatment. In this study, we investigated the newly formulated calcium-based resorbable bone substitute materials containing either gentamicin (CaSO4-G [Herafill-G]), vancomycin (CaSO4-V), or tobramycin (Osteoset). We characterized the released antibiotic concentration per unit. Bone substitute materials were implanted in bones of rabbits via a standardized surgical procedure. Clinical parameters and levels of the antibiotic-releasing materials in serum were determined. Local concentrations of antibiotics were measured using antimicrobial tests of bone tissue. Aminoglycoside release kinetics in vitro per square millimeter of bead surface showed the most prolonged release for gentamicin, followed by vancomycin and, with the fastest release, tobramycin. In vivo level in serum detected over 28 days was highest for gentamicin at 0.42 μg/ml, followed by vancomycin at 0.11 μg/ml and tobramycin at 0.04 μg/ml. The clinical parameters indicated high biocompatibility for materials used. None of the rabbits subjected to the procedure showed any adverse reaction. The highest availability of antibiotics at 14.8 μg/g on day 1 in the cortical tibia ex vivo was demonstrated for gentamicin, decreasing within 14 days. In the medulla, vancomycin showed a high level at 444 μg/g on day 1, decreasing continuously over 14 days, whereas gentamicin decreased faster within the initial 3 days. The compared antibiotic formulations varied significantly in release kinetics in serum as well as locally in medulla and cortex. PMID:27067337

  3. NOTE: New tissue substitutes representing cortical bone and adipose tissue in quantitative radiology

    NASA Astrophysics Data System (ADS)

    Sanada, Shigeru; Kawahara, Kazuhiro; Yamamoto, Tomoyuki; Takashima, Tsutomu

    1999-06-01

    To employ quantitative radiology more accurately, we examined phantom materials for cortical bone and adipose tissue as calibration standards and as experimental phantoms. New tissue substitutes for cortical bone and adipose tissue composed of liquid phantom were verified by computing their attenuation coefficients and observing their chemical properties. We showed that a potassium pyrophosphate (K4P2O7) solution for cortical bone was comparable to a dipotassium hydrogen phosphate (K2HPO4) solution. Also, the use of methyl alcohol for adipose tissue was more suitable than ethyl alcohol as a phantom material because of its physical and chemical properties.

  4. [Study on the preparation and application of individual artificial bone with carbon/carbon composites].

    PubMed

    Ni, Xinye; Qian, Nong; Zhou, Dong; Miao, Yunliang; Xiong, Xinbo; Lin, Tao; Chen, Da; Zhao, Gongyin; Zhong, Ping

    2013-12-01

    The present paper is aimed to study the preparation and application of individual artificial bone of carbon/carbon composites. Using computer tomography images (CT), we acquired a three-dimensional image. Firstly, we described bone contour line outlined with manual and automatic method by the binary volume data. Secondly, we created 3D object surface information by marching cubes. Finally, we converted this information to non-uniform rational B-spine (NURBS) by using geomagic software. Individual artificial bone with carbon/carbon composite was prepared through the CNC Machining Center. We replaced the humeral head of the tested rabbit, and then observed the effects of implantation in neuroimaging and pathological section. Using this method, we found that the bone shape processed and bone shape replaced was consistent. After implantation, the implant and the surrounding bone tissue bound closely, and bone tissue grew well on the surface of the implant. It has laid a sound foundation of the preparation using this method for individual artificial bone of carbon/carbon composite material.

  5. [Application of three-dimensional printing technique in artificial bone fabrication for bone defect after mandibular angle ostectomy].

    PubMed

    Shen, Congcong; Zhang, Yan; Li, Qingfeng; Zhu, Ming; Hou, Yikang; Qu, Miao; Xu, Yourong; Chai, Gang

    2014-03-01

    To investigate the application of three-dimensional (3-D) printing technique combining with 3-D CT and computer aided-design technique in customized artificial bone fabrication, correcting mandibular asymmetry deformity after mandibular angle ostectomy. Between April 2011 and June 2013, 23 female patients with mandibular asymmetry deformity after mandibular angle ostectomy were treated. The mean age was 27 years (range, 22-34 years). The disease duration of mandibular asymmetry deformity was 6-16 months (mean, 12 months). According to the CT data and individualized mandibular angle was simulated based on mirror theory, 3-D printed implants were fabricated as the standard reference for manufacturers to fabricated artificial bone graft, and then mandible repair operation was performed utilizing the customized artificial bone to improve mandibular asymmetry. The operation time varied from 40 to 60 minutes (mean, 50 minutes). Primary healing of incisions was obtained in all patients; no infection, hematoma, and difficulty in opening mouth occurred. All 23 patients were followed up 3-10 months (mean, 6.7 months). After operation, all patients obtained satisfactory facial and mandibular symmetry. 3-D CT reconstructive examination results after 3 months of operation showed good integration of the artificial bone. 3-D printing technique combined with 3-D CT and computer aided design technique can be a viable alternative to the approach of maxillofacial defects repair after mandibular angle ostectomy, which provides a accurate and easy way.

  6. Effect of fluoride-substituted apatite on in vivo bone formation.

    PubMed

    Inoue, Miho; Rodriguez, Andrea P; Nagai, Noriyuki; Nagatsuka, Hitoshi; LeGeros, Racquel Z; Tsujigiwa, Hidetsugu; Inoue, Masahisa; Kishimoto, Etsuo; Takagi, Shin

    2011-05-01

    Biological apatites are characterized by the presence of minor constituents such as magnesium (Mg), chloride (Cl), or fluoride (F) ions. These ions affect cell proliferation and osteoblastic differentiation during bone tissue formation. F-substituted apatites are being explored as potential bonegraft materials. The aim of the present study is to investigate the mechanism of bone formation induced by fluoride-substituted apatite (FAp) by analyzing the effect of FAp on the process of in vivo bone formation. FAps containing different F concentrations (l-FAp: 0.48 wt%, m-FAp: 0.91 wt%, h-FAp: 2.23 wt%) and calcium-deficient apatite (CDA), as positive control, were implanted in rat tibia and bone formation was evaluated by histological examination, immuhistochemistry, in situ hybridization and tartrate-resistant acid phosphatase examinations. The results showed that l-FAp, m-FAp, h-FAp, and CDA biomaterials allowed migration of macrophages, attachment, proliferation, and phenotypic expression of bone cells leading to new bone formation in direct apposition to the particles. However, the l-FAp preparation allowed faster bone conduction compared to the other experimental materials. These results suggest that FAp with low F concentration may be an efficient bonegraft material for dental and medical application.

  7. Bone marrow mesenchymal stem cells, platelet-rich plasma and nanohydroxyapatite-type I collagen beads were integral parts of biomimetic bone substitutes for bone regeneration.

    PubMed

    Lin, Bo-Nian; Whu, Shu Wen; Chen, Chih-Hwa; Hsu, Fu-Yin; Chen, Jyh-Cheng; Liu, Hsia-Wei; Chen, Chien-Hao; Liou, Hau-Min

    2013-11-01

    Platelet rich plasma (PRP), which includes many growth factors, can activate osteoid production, collagen synthesis and cell proliferation. Nanohydroxyapatite-type I collagen beads (CIB), which mimetic natural bone components, are not only flexible fillers for bone defect but also encourage osteogenesis. Bone marrow mesenchymal stem cells (BMSCs) are often used as an abundant cell source for tissue engineering. We used a rabbit model to combine PRP, CIB and BMSCs (CIB+PRP+BMSC) into a bone-like substitute to study its impact on bone regeneration, when compared to defect alone, PRP, CIB+PRP, and PRP+BMSC. CIB+PRP upregulated more alkaline phosphatase (ALP) activity in BMSCs than PRP alone at 4 weeks postoperation. CIB+PRP+BMSC and PRP+BMSC did not differ significantly in DNA content, total collagen content, and ALP activity at 8 weeks. In histological assay, both CIB+PRP+BMSC and PRP+BMSC showed more bone regeneration at 4 and 8 weeks. Higher trabecular bone volume in tissue volume (BV/TV) (31.15±2.67% and 36.93±1.01%), fractal dimension (FD) (2.30±0.18 and 2.65±0.02) and lower trabecular separation (Tb.Sp) (2.30±0.18 and 1.35±0.16) of CIB+PRP+BMSC than of other groups at 4 and 8 weeks, and approach to of bone tissue (BV/TV=24.35±2.13%; FD=2.65±0.06; Tb.Sp=4.19±0.95). CIB+PRP+BMSC significantly enhanced new bone formation at 4 week. Therefore, nanohydroxyapatite-type I collagen beads combined with PRP and BMSCs produced a bone substitute with efficiently improved bone regeneration that shows promise to repair bone defects.

  8. New Bismuth-Substituted Hydroxyapatite Nanoparticles for Bone Tissue Engineering

    NASA Astrophysics Data System (ADS)

    Ciobanu, Gabriela; Bargan, Ana Maria; Luca, Constantin

    2015-11-01

    New bismuth-substituted hydroxyapatite [Ca10- x Bi x (PO4)6(OH)2 where x = 0-2.5] nanoparticles were synthesized by the co-precipitation method from aqueous solutions. The structural properties of the samples were analyzed by scanning electron microscopy coupled with x-ray analysis, x-ray powder diffraction, x-ray photoelectron spectroscopy, Fourier transform infrared spectroscopy and Brunauer-Emmett-Teller surface area analysis. The results confirm that bismuth ions have been incorporated into the hydroxyapatite lattice. The prepared nanocrystalline powders consisted of hydroxyapatite as single phase with hexagonal structure, crystal sizes smaller than 60 nm and (Bi + Ca)/P atomic ratio of around 1.67. The hydroxyapatite samples doped with Bi have mesoporous textures with pores size of around 2 nm and specific surface area in the range of 12-25 m2/g. The Bi-substituted hydroxyapatite powders are more effective against Gram-negative Escherichia coli bacteria than Gram-positive Staphylococcus aureus bacteria.

  9. The necessity of selenium substitution in total parenteral nutrition and artificial alimentation.

    PubMed

    Gramm, H J; Kopf, A; Brätter, P

    1995-03-01

    For the trace element selenium, in contrast to zinc, iron, copper, chromium, manganese and iodine, there is still no clear official recommendation with regard to routine substitution in artificial nutrition. An overview of the manifestations of selenium deficiency in humans during the period 1979-1995 shows that nutritive deficiencies are exclusively TPN-induced or the result of severe malnutrition. The pathology of TPN-induced selenium deficiency and the analytic assessment of selenium status are described. Patients undergoing long-term parenteral nutrition or suffering from an increased loss of intestinal secretions have to be characterized as being especially at risk for clinical selenium deficiency. The relationship of the serum selenium kinetics in pediatric and adult patients to the depletion of body compartments during the course of short-term and prolonged TPN is discussed. Because of the importance of the selenoproteins, the regularly occurring depletion during selenium-free TPN and the borderline supply of selenium in Germany the routine substitution of selenium in TPN is strongly recommended. The pharmaceutical industry should be encouraged to develop a trace element solution that includes selenium, so that the nutritive requirement of patients on TPN can be satisfied. Adequate intravenous dosage recommendations are based on maintenance of glutathione peroxidase homeostasis. The routine supplementation dosage may not meet the selenium requirements of intensive care patients under conditions of increased metabolic demands on their anti-oxidative system.

  10. Doped Calcium Silicate Ceramics: A New Class of Candidates for Synthetic Bone Substitutes

    PubMed Central

    No, Young Jung; Li, Jiao Jiao; Zreiqat, Hala

    2017-01-01

    Doped calcium silicate ceramics (DCSCs) have recently gained immense interest as a new class of candidates for the treatment of bone defects. Although calcium phosphates and bioactive glasses have remained the mainstream of ceramic bone substitutes, their clinical use is limited by suboptimal mechanical properties. DCSCs are a class of calcium silicate ceramics which are developed through the ionic substitution of calcium ions, the incorporation of metal oxides into the base binary xCaO–ySiO2 system, or a combination of both. Due to their unique compositions and ability to release bioactive ions, DCSCs exhibit enhanced mechanical and biological properties. Such characteristics offer significant advantages over existing ceramic bone substitutes, and underline the future potential of adopting DCSCs for clinical use in bone reconstruction to produce improved outcomes. This review will discuss the effects of different dopant elements and oxides on the characteristics of DCSCs for applications in bone repair, including mechanical properties, degradation and ion release characteristics, radiopacity, and biological activity (in vitro and in vivo). Recent advances in the development of DCSCs for broader clinical applications will also be discussed, including DCSC composites, coated DCSC scaffolds and DCSC-coated metal implants. PMID:28772513

  11. Comparing the Efficacy of Three Different Nano-scale Bone Substitutes: In vivo Study.

    PubMed

    Razavi, Sayed Mohammad; Rismanchian, Mansour; Jafari-Pozve, Nasim; Nosouhian, Saied

    2017-01-01

    Synthetic biocompatible bone substitutions have been used widely for bone tissue regeneration as they are safe and effective. The aim of this animal study is to compare the effectiveness of three different biocompatible bone substitutes, including nano-hydroxyapatite (nano-HA) nano-bioglass (nano-BG) and forstrite scaffolds. In this interventional and experimental study, four healthy dogs were anesthetized, and the first to fourth premolars were extracted in each quadrant. After healing, the linear incision on the crestal ridge from molar to anterior segment prepared in each quadrant and 16 defects in each dog were prepared. Nano-HA, nano-BG, and forstrite scaffold was prepared according to the size of defects and placed in the 12 defects randomly, four defects remained as a control group. The dogs were sacrificed in four time intervals (15, 30, 45, and 60 days after) and the percentage of different types of regenerated bones (lamellar and woven) and connective tissue were recorded in histological process. The data were analyzed using Mann-Whitney test (α = 0.05). The difference in nano-HA and nano-BG with the control group was significant in three-time intervals regarding the amount of bone formation (P < 0.01). After 15 days, the nano-HA showed the highest amount of woven and lamellar bone regeneration (18.37 ± 1.06 and 30.44 ± 0.54). Nano-HA and nano-BG groups showed a significant amount of bone regeneration, especially after 30 days, but paying more surveys and observation to these materials as bone substitutes seem to be needed.

  12. Supercritical carbon dioxide-processed resorbable polymer nanocomposites for bone graft substitute applications

    NASA Astrophysics Data System (ADS)

    Baker, Kevin C.

    Numerous clinical situations necessitate the use of bone graft materials to enhance bone formation. While autologous and allogenic materials are considered the gold standards in the setting of fracture healing and spine fusion, their disadvantages, which include donor site morbidity and finite supply have stimulated research and development of novel bone graft substitute materials. Among the most promising candidate materials are resorbable polymers, composed of lactic and/or glycolic acid. While the characteristics of these materials, such as predictable degradation kinetics and biocompatibility, make them an excellent choice for bone graft substitute applications, they lack mechanical strength when synthesized with the requisite porous morphology. As such, porous resorbable polymers are often reinforced with filler materials. In the presented work, we describe the use of supercritical carbon dioxide (scCO2) processing to create porous resorbable polymeric constructs reinforced by nanostructured, organically modified Montmorillonite clay (nanoclay). scCO2 processing simultaneously disperses the nanoclay throughout the polymeric matrix, while imparting a porous morphology to the construct conducive to facilitating cellular infiltration and neoangiogenesis, which are necessary components of bone growth. With the addition of as little as 2.5wt% of nanoclay, the compressive strength of the constructs nearly doubles putting them on par with human cortico-cancellous bone. Rheological measurements indicate that the dominant mode of reinforcement of the nanocomposite constructs is the restriction of polymer chain mobility. This restriction is a function of the positive interaction between polymer chains and the nanoclay. In vivo inflammation studies indicate biocompatibility of the constructs. Ectopic osteogenesis assays have determined that the scCO2-processed nanocomposites are capable of supporting growth-factor induced bone formation. scCO 2-processed resorbable

  13. Staining undecalcified bone sections a modified technique for an improved visualization of synthetic bone substitutes.

    PubMed

    Mayr-Wohlfart, U; Ravalli, G; Günther, K P; Kessler, S

    2008-12-01

    We describe a detailed embedding procedure for large bone specimens in methyl methacrylate and a new staining method by which thin sections (appr 100 um) of undecalcified bones with synthetic implants can be coloured. Different staining effects were obtained which greatly facilitated the evaluation of sections with bone, new forming bone and especially remnants of synthetic implants. The identification and quantification of the latter is difficult in common staining techniques. A detailed embedding - staining - mounting procedure is proposed.

  14. Automating the Processing Steps for Obtaining Bone Tissue-Engineered Substitutes: From Imaging Tools to Bioreactors

    PubMed Central

    Costa, Pedro F.; Martins, Albino; Neves, Nuno M.; Gomes, Manuela E.

    2014-01-01

    Bone diseases and injuries are highly incapacitating and result in a high demand for tissue substitutes with specific biomechanical and structural features. Tissue engineering has already proven to be effective in regenerating bone tissue, but has not yet been able to become an economically viable solution due to the complexity of the tissue, which is very difficult to be replicated, eventually requiring the utilization of highly labor-intensive processes. Process automation is seen as the solution for mass production of cellularized bone tissue substitutes at an affordable cost by being able to reduce human intervention as well as reducing product variability. The combination of tools such as medical imaging, computer-aided fabrication, and bioreactor technologies, which are currently used in tissue engineering, shows the potential to generate automated production ecosystems, which will, in turn, enable the generation of commercially available products with widespread clinical application. PMID:24673688

  15. Injectable bone-graft substitutes: current products, their characteristics and indications, and new developments.

    PubMed

    Larsson, Sune; Hannink, Gerjon

    2011-09-01

    More than a decade has passed since the first injectable bone substitutes were introduced for use in orthopaedic trauma, and over recent years the number of commercial products has increased dramatically. Despite the fact that these bone substitutes have been on the market for many years, knowledge amongst potential users on how and when they might be useful is still fairly limited. Most injectable bone substitutes belong to one of two major groups: by far the largest group contains products based on various calcium phosphate (CP) mixtures, whilst the smaller group consists of calcium sulphate (CS) compounds. Following mixing, the CP or CS paste can be injected into--for instance--a fracture space for augmentation as an alternative to bone graft, or around a screw for augmentation if the bone is weak. Within minutes an in situ process makes the substitute hard; the mechanical strength in compression resembles that of cancellous bone, whereas the strength in bending and shear is lower. Over time, CP products undergo remodelling through a cell-mediated process that seems to mimic the normal bone remodelling, whilst CS products are dissolved through a faster process that is not cell-mediated. For CP, a number of clinical studies have shown that it can be useful for augmentation of metaphyseal fractures when a space is present. Randomised studies have verified that CP works especially well in tibial plateau fractures when compared with conventional bone grafting. So far the number of clinical studies on CS products is very low. Development at present seems to be heading towards premixed or directly mixed products as well as new compounds that contain fibres or other components to enhance bending and shear strength. Products that are based on combinations of CP and CS are also being developed to combine the fast-dissolving CS with the stronger and more slowly remodelling CP. Injectable bone substitutes, and especially CS, have also been targeted as potentially good

  16. Injectability of brushite-forming Mg-substituted and Sr-substituted alpha-TCP bone cements.

    PubMed

    Pina, S; Torres, P M C; Ferreira, J M F

    2010-02-01

    The influence of magnesium- and strontium-substitutions on injectability and mechanical performance of brushite-forming alpha-TCP cements has been evaluated in the present work. The effects of Mg- and Sr-substitutions on crystalline phase composition and lattice parameters were determined through quantitative X-ray phase analysis and structural Rietveld refinement of the starting calcium phosphate powders and of the hardened cements. A noticeable dependence of injectability on the liquid-to-powder ratio (LPR), smooth plots of extrusion force versus syringe plunger displacement and the absence of filter pressing effects were observed. For LPR values up to 0.36 ml g(-1), the percentage of injectability was always higher and lower for Mg-containing cements and for Sr-containing cements, respectively, while all the pastes could be fully injected for LPR > 0.36 ml g(-1). The hardened cements exhibited relatively high wet compressive strength values (~17-25 MPa) being the Sr- and Mg-containing cements the strongest and the weakest, respectively, holding an interesting promise for uses in trauma surgery such as for filling bone defects and in minimally invasive techniques such as percutaneous vertebroplasty to fill lesions and strengthen the osteoporotic bone.

  17. Evaluation of injectable silica-embedded nanohydroxyapatite bone substitute in a rat tibia defect model

    PubMed Central

    Xu, Weiguo; Ganz, Cornelia; Weber, Ulf; Adam, Martin; Holzhüter, Gerd; Wolter, Daniel; Frerich, Bernhard; Vollmar, Brigitte; Gerber, Thomas

    2011-01-01

    In clinical practice, vertebral compression fractures occur after trauma and osteoporosis. Kyphoplasty is a minimally invasive procedure using bone filler material for the treatment of such fractures. A full synthetic injectable bone substitute (SIBS) was manufactured by means of spray drying. The aim of this study was to characterize the SIBS and to analyze the remodelling process during degradation of the biomaterial and new bone formation after implantation. SIBS is an aqueous suspension of donut-like microparticles. These microparticles consist of nanocrystallites of synthetic hydroxyapatite embedded in amorphous silica gel. After implantation of SIBS in a proximal tibial diaphyseal defect in 52 rats, grafts were harvested for subsequent analysis on different days. Newly formed bone originating from endosteum was observed on day 6. Hematomas in the medullary space and cortical wounds disappeared on day 12. The wound region was completely replaced by a composite of newly formed cancellous bone, extracellular matrix, and SIBS. At day 63 the cortical defect was fully healed by bone, while newly formed bone in the medullary space almost disappeared and was replaced with bone marrow. In conclusion, SIBS demonstrated a unique structure with osteoinductive and bioresorbable properties, which induced fast bone regeneration. Therefore, a clinical application of SIBS for kyphoplasty is promising. PMID:21845044

  18. [A comparative morphometric and histologic study of five bone substitute materials].

    PubMed

    Chen, L; Klaes, W; Assenmacher, S

    1996-07-01

    To investigate and compare the osteogenesis of bone substitute materials. 52 Chbb: ch rabbits were divided into 5 groups. Five different porous biomaterials, including natural bovine hydroxyapatite (Bio-OSS, BK V/1), semi-synthetic coral hydroxyapatite interpore 500, synthetic tricalcium phosphate CEROS 82 and glass POROLITH, were implanted together with free periosteum into the muscle of rabbits for up to 3 and 6 weeks. Undecalcified sections were prepared for microradiography, light and UV microscopy, and morphometry. Bone ingrowth was present in all such implantats. Bone formation was limited to the periphery of the Ceros blocks, that are lack of pore interconnection, while the other 4 materials with an interconnected porous system were infiltrated by bone into the centrum. Planimetric analyses showed that the specimens were composed of 6.5%-19.0% new bone at the 3rd week and 14.2%-25% at the 6th week respectively. The difference of bone ingrowth was only significant between Bio-OSS and BK V/1 at the 3rd week. No statistically significant difference of bone volume was found within the 6 week groups. There was a positive correlation between the new bone volume and the porosity of the materials. For the bone ingrowth, the structure of the materials, specifically the pore and pore interconnections, is more impatant than the chemical composition.

  19. Sinus Floor Elevation and Augmentation Using Synthetic Nanocrystalline and Nanoporous Hydroxyapatite Bone Substitute Materials: Preliminary Histologic Results.

    PubMed

    Belouka, Sofia-Maria; Strietzel, Frank Peter

    To compare the tissue composition of augmented sites after using two different synthetic bone substitute materials, nanocrystalline and nanoporous hydroxyapatite (HA), for sinus floor elevation and augmentation. Forty-four patients received 88 titanium screw implants (Camlog Promote plus) of 4.3-mm diameter and 11- or 13-mm length, placed simultaneously during sinus floor elevation and augmentation. Nanocrystalline (Ostim) or nanoporous (NanoBone) HA were used exclusively. Bone substitute materials and implant lengths were allocated by randomization. Bone biopsy specimens were obtained from the former area of the lateral access window at implant exposure during healing abutment placement after 6 months. Biopsy specimens were prepared and examined histologically and histomorphometrically. All implants were osseointegrated at the time of exposure. Clinically and histologically, no signs of inflammation in the augmented sites were present. The histomorphometric analysis of 44 biopsy specimens revealed 31.8% ± 11.6% newly formed bone for sites augmented with nanocrystalline HA and 34.6% ± 9.2% for nanoporous HA (P = .467). The proportion of remaining bone substitute material was 28.4% ± 18.6% and 30% ± 13%, respectively (P = .453). The proportion of soft tissue within the biopsy specimens was 39.9% ± 11.1% and 35.4% ± 6.8%, respectively (P = .064). No significant differences were found between the area fractions of bone, bone substitute material, and soft tissue concerning the bone substitute material utilized. Within the present study, both synthetic bone substitute materials, nanocrystalline and nanoporous HA, were found to support bone formation in sinus floor elevation and augmentation procedures by osteoconductivity. They were not completely resorbed after 6 months. The amounts of newly formed bone, soft tissue, and bone substitute material remnants were found to be similar, indicating that both materials are likewise suitable for sinus floor elevation and

  20. Directly auto-transplanted mesenchymal stem cells induce bone formation in a ceramic bone substitute in an ectopic sheep model

    PubMed Central

    Boos, Anja M; Loew, Johanna S; Deschler, Gloria; Arkudas, Andreas; Bleiziffer, Oliver; Gulle, Heinz; Dragu, Adrian; Kneser, Ulrich; Horch, Raymund E; Beier, Justus P

    2011-01-01

    Abstract Bone tissue engineering approaches increasingly focus on the use of mesenchymal stem cells (MSC). In most animal transplantation models MSC are isolated and expanded before auto cell transplantation which might be critical for clinical application in the future. Hence this study compares the potential of directly auto-transplanted versus in vitro expanded MSC with or without bone morphogenetic protein-2 (BMP-2) to induce bone formation in a large volume ceramic bone substitute in the sheep model. MSC were isolated from bone marrow aspirates and directly auto-transplanted or expanded in vitro and characterized using fluorescence activated cell sorting (FACS) and RT-PCR analysis before subcutaneous implantation in combination with BMP-2 and β-tricalcium phosphate/hydroxyapatite (β-TCP/HA) granules. Constructs were explanted after 1 to 12 weeks followed by histological and RT-PCR evaluation. Sheep MSC were CD29+, CD44+ and CD166+ after selection by Ficoll gradient centrifugation, while directly auto-transplanted MSC-populations expressed CD29 and CD166 at lower levels. Both, directly auto-transplanted and expanded MSC, were constantly proliferating and had a decreasing apoptosis over time in vivo. Directly auto-transplanted MSC led to de novo bone formation in a heterotopic sheep model using a β-TCP/HA matrix comparable to the application of 60 μg/ml BMP-2 only or implantation of expanded MSC. Bone matrix proteins were up-regulated in constructs following direct auto-transplantation and in expanded MSC as well as in BMP-2 constructs. Up-regulation was detected using immunohistology methods and RT-PCR. Dense vascularization was demonstrated by CD31 immunohistology staining in all three groups. Ectopic bone could be generated using directly auto-transplanted or expanded MSC with β-TCP/HA granules alone. Hence BMP-2 stimulation might become dispensable in the future, thus providing an attractive, clinically feasible approach to bone tissue engineering. PMID

  1. Directly auto-transplanted mesenchymal stem cells induce bone formation in a ceramic bone substitute in an ectopic sheep model.

    PubMed

    Boos, Anja M; Loew, Johanna S; Deschler, Gloria; Arkudas, Andreas; Bleiziffer, Oliver; Gulle, Heinz; Dragu, Adrian; Kneser, Ulrich; Horch, Raymund E; Beier, Justus P

    2011-06-01

    Bone tissue engineering approaches increasingly focus on the use of mesenchymal stem cells (MSC). In most animal transplantation models MSC are isolated and expanded before auto cell transplantation which might be critical for clinical application in the future. Hence this study compares the potential of directly auto-transplanted versus in vitro expanded MSC with or without bone morphogenetic protein-2 (BMP-2) to induce bone formation in a large volume ceramic bone substitute in the sheep model. MSC were isolated from bone marrow aspirates and directly auto-transplanted or expanded in vitro and characterized using fluorescence activated cell sorting (FACS) and RT-PCR analysis before subcutaneous implantation in combination with BMP-2 and β-tricalcium phosphate/hydroxyapatite (β-TCP/HA) granules. Constructs were explanted after 1 to 12 weeks followed by histological and RT-PCR evaluation. Sheep MSC were CD29(+), CD44(+) and CD166(+) after selection by Ficoll gradient centrifugation, while directly auto-transplanted MSC-populations expressed CD29 and CD166 at lower levels. Both, directly auto-transplanted and expanded MSC, were constantly proliferating and had a decreasing apoptosis over time in vivo. Directly auto-transplanted MSC led to de novo bone formation in a heterotopic sheep model using a β-TCP/HA matrix comparable to the application of 60 μg/ml BMP-2 only or implantation of expanded MSC. Bone matrix proteins were up-regulated in constructs following direct auto-transplantation and in expanded MSC as well as in BMP-2 constructs. Up-regulation was detected using immunohistology methods and RT-PCR. Dense vascularization was demonstrated by CD31 immunohistology staining in all three groups. Ectopic bone could be generated using directly auto-transplanted or expanded MSC with β-TCP/HA granules alone. Hence BMP-2 stimulation might become dispensable in the future, thus providing an attractive, clinically feasible approach to bone tissue engineering.

  2. Cholinergic nerve fibers in bone defects of a rat osteoporosis model and their regulation by implantation of bone substitution materials.

    PubMed

    Lips, K S; Kauschke, V; Hartmann, S; Thormann, U; Ray, S; Schumacher, M; Gelinsky, M; Heinemann, S; Hanke, T; Kautz, A R; Schnabelrauch, M; Szalay, G; Heiss, C; Schnettler, R; Alt, V; Kilian, O

    2014-06-01

    Bone is innervated by autonomic nervous system that consists of sympathetic and parasympathetic nerves that were recently identified in bone. Thus we asked whether parasympathetic nerves occur in bone defects and at the interface of substitution materials that were implanted for stabilization and improvement of healing in an osteoporosis animal model. Osteoporosis was induced in rats by ovariectomy and deficiency diet. A wedge-shaped osteotomy was performed in the metaphyseal area of femur. Eight different implants were inserted that were based on calcium phosphate cement, iron, silica-mineralized collagen, and modifications with strontium. Nerves were identified by immunohistochemistry with antibodies against vesicular acetylcholine transporter (VAChT), tyrosine hydroxylase (TH) and protein gene product 9.5 (PGP 9.5) as neuronal marker. Cholinergic nerves identified with VAChT immunostaining were detected in defects filled with granulation tissue and in surrounding mast cells. No immunolabeling of cholinergic nerves was found after implantation. The general presence of nerves was reduced after implantation as shown by PGP 9.5. Sympathetic nerves identified by TH immunolabeling were increased in strontium functionalized materials. Since cholinergic innervation was diminished after implantation a further increase in the compatibility of substitution materials to nerves could improve defect healing especially in osteoporotic bone.

  3. On the properties of artificial neural network filters for bone-suppressed digital radiography

    NASA Astrophysics Data System (ADS)

    Park, Eunpyeong; Park, Junbeom; Kim, Daecheon; Youn, Hanbean; Jeon, Hosang; Kim, Jin Sung; Kang, Dong-Joong; Kim, Ho Kyung

    2016-04-01

    Dual-energy imaging can enhance lesion conspicuity. However, the conventional (fast kilovoltage switching) dual-shot dual-energy imaging is vulnerable to patient motion. The single-shot method requires a special design of detector system. Alternatively, single-shot bone-suppressed imaging is possible using post-image processing combined with a filter obtained from training an artificial neural network. In this study, the authors investigate the general properties of artificial neural network filters for bone-suppressed digital radiography. The filter properties are characterized in terms of various parameters such as the size of input vector, the number of hidden units, the learning rate, and so on. The preliminary result shows that the bone-suppressed image obtained from the filter, which is designed with 5,000 teaching images from a single radiograph, results in about 95% similarity with a commercial bone-enhanced image.

  4. A novel alkali metals/strontium co-substituted calcium polyphosphate scaffolds in bone tissue engineering.

    PubMed

    Song, Wei; Wang, Qiguang; Wan, Changxiu; Shi, Tong; Markel, David; Blaiser, Ralph; Ren, Weiping

    2011-08-01

    Our purpose of this study is to develop potassium or sodium/strontium co-substituted calcium polyphosphate (K/Sr-CPP or Na/Sr-CPP) bioceramics in application of bone repairing scaffold. The incorporation of K, Na, and Sr into CPP substrate via a calcining-sintering process was confirmed by X-ray diffractometry and inductively coupled plasma atomic emission spectroscopy. In vitro degradation study of co-substituted CPP indicated the incorporation of alkali metal elements promoted the degradability of CPP, and the scanning electron microscope showed the apatite-like minerals were precipitated on the surface of co-substituted CPP. The compress resistant strength of co-substituted CPP was elevated by dopants. The MTT assay and confocal laser-scanning microscope on osteoblasts culturing with co-substituted CPP showed no cytotoxicity. The cell proliferation on co-substituted CPP was even better than others. Thus, this co-substituted CPP bioceramics might have potential of applications in orthopedic field.

  5. Evaluation of suitable porosity for sintered porous {beta}-tricalcium phosphate as a bone substitute

    SciTech Connect

    Park, Jin-Hong; Bae, Ji-Yong; Shim, Jaebum; Jeon, Insu

    2012-09-15

    Structural and mechanical characterization is performed for sintered porous beta tricalcium phosphate ({beta}-TCP) to determine the appropriate porosity for use as a bone substitute. Four different types of porous {beta}-TCP specimen with different porosities are fabricated through a sintering process. For structural characterization, scanning electron microscopy and a Microfocus X-ray computed tomography system are used to investigate the pore openings on the specimen's surface, pore size, pore distribution, and pore interconnections. Compression tests of the specimens are performed, and mechanical properties such as the elastic modulus and compressive strength are obtained. Also, the geometric shape and volume of the {beta}-TCP around the contact region of two pores, which need to be initially resolved after implantation in order to increase the size of the pore openings, are evaluated through simple calculations. The results show that porous {beta}-TCP with 42.1% porosity may be a suitable bone substitute candidate in terms of sustaining external loads, and inducing and cultivating bone cells. - Highlights: Black-Right-Pointing-Pointer Structural and mechanical characterization was performed for sintered porous {beta}-TCP specimens. Black-Right-Pointing-Pointer For structural characterization, SEM and Microfocus X-ray CT system were used. Black-Right-Pointing-Pointer For mechanical characterization, compression tests were performed. Black-Right-Pointing-Pointer Porous {beta}-TCP with 42.1% porosity may be a suitable bone substitute.

  6. Use of bone graft substitutes in the management of tibial plateau fractures.

    PubMed

    Goff, Thomas; Kanakaris, Nikolaos K; Giannoudis, Peter V

    2013-01-01

    The current available evidence for the use of bone graft substitutes in the management of subchondral bone defects associated with tibial plateau fractures as to their efficiency and safety has been collected following a literature review of the Ovid MEDLINE (1948-Present) and EMBASE (1980-Present). Nineteen studies were analysed reporting on 672 patients (674 fractures), with a mean age of 50.35 years (range 15-89), and a gender ratio of 3/2 males/females. The graft substitutes evaluated in the included studies were calcium phosphate cement, hydroxyapatite granules, calcium sulphate, bioactive glass, tricalcium phosphate, demineralised bone matrix, allografts, and xenograft. Fracture healing was uneventful in over 90% of the cases over a variant period of time. Besides two studies reporting on injectable calcium phosphate cement excellent incorporation was reported within 6 to 36 months post-surgery. No correlation was made by any of the authors between poor incorporation/resorption and adverse functional or radiological outcome. Secondary collapse of the knee joint surface ≥ 2 mm was reported in 8.6% in the biological substitutes (allograft, DBM, and xenograft), 5.4% in the hydroxyapatite, 3.7% in the calcium phosphate cement, and 11.1% in the calcium sulphate cases. The recorded incidence of primary surgical site and donor site infection (3.6%) was not statistically significant different, however donor site-related pain was reported up to 12 months following autologous iliac bone graft (AIBG) harvest. Shorter total operative time, greater tolerance of early weight bearing, improved early functional outcomes within the first year post-surgery was also recorded in the studies reporting on the use of injectable calcium phosphate cement (Norian SRS). Despite a lack of good quality randomised control trials, there is arguably sufficient evidence supporting the use of bone graft substitutes at the clinical setting of depressed plateau fractures.

  7. Platelet leukocyte gel facilitates bone substitute growth and autologous bone growth in a goat model.

    PubMed

    Everts, Peter A M; Delawi, Diyar; Mahoney, Christine Brown; van Erp, Albert; Overdevest, Eddy P; van Zundert, André; Knape, Johannes T A; Dhert, Wouter J A

    2010-02-01

    The aim of this study is to evaluate multiple conditions on the formation of bone growth in a goat model. We prepared from a unit of whole blood, platelet-leukocyte gel (PLG) to stimulate bone formation, based on the release of platelet growth factors. Two 3-compartment cages containing autologous bone, calcium phosphate, and trabecular metal were implanted onto goat spinal transverse processes. One cage was treated with PLG, prepared according to a standardized protocol. An untreated cage served as a control. To monitor bone formation overtime, fluorochrome markers were administered at 2, 3, and 5 weeks. Animals were sacrificed at 9 weeks after implantation. Bone growth in these 3-compartments cages was examined by histology and histomorphometry of nondecalcified sections using traditional light and epifluorescent microscopy. Compared to the control samples, bone growth in the PLG-treated autologous bone and calcium phosphate samples was significantly more. Fairly little bone growth was seen in PLG treated or untreated trabecular metal scaffolds. The results obtained from this goat model suggest a potential role for the application of autologous PLG during surgeries in which autologous bone grafts or calcium phosphate scaffolds are used.

  8. Synthesis and enhanced bone regeneration of carbonate substituted octacalcium phosphate.

    PubMed

    Shen, Donghe; Horiuchi, Naohiro; Nozaki, Sosuke; Miyashin, Michiyo; Yamashita, Kimihiro; Nagai, Akiko

    2017-01-01

    Using a wet method, we have synthesized octacalcium phosphate carbonate, in which HPO42- in octacalcium phosphate is replaced with CO32-. The physical, crystal, and chemical properties of this new material were compared to octacalcium phosphate, Ca-deficient hydroxyapatite, and Ca-deficient carbonate apatite using X-ray diffraction, Fourier-transform infrared spectroscopy, inductively coupled plasma spectroscopy, and scanning electron microscopy. Surface roughness and morphology were also characterized, along with the ability to support proliferation and differentiation of MG63 cells, as measured by MTT and alkaline phosphatase assay. We found that octacalcium phosphate carbonate enhanced osteoblast proliferation more strongly than all other materials tested. Similarly, Ca-deficient carbonate apatite, a hydrolysate of octacalcium phosphate carbonate, stimulated osteoblast differentiation to a better extent than Ca-deficient hydroxyapatite, a carbonate-free hydrolysate of octacalcium phosphate. These results indicate that octacalcium phosphate carbonate has good biocompatibility and osteoconduction, and incorporation of carbonate into octacalcium phosphate and apatite enhances bone regeneration.

  9. Evaluation of a bone substitute prepared from alpha-tricalcium phosphate and an acid polysaccharide solution.

    PubMed

    Nagase, M; Chen, R B; Araya, Y; Nakajima, T

    1991-12-01

    Tissue response to a readily consolidating material prepared by mixing alpha-tricalcium phosphate (alpha-TCP) powder with a glycolic acid dextran solution and to this consolidating material combined with particulate hydroxylapatite (HA) was studied after implantation in the subperiosteal space of the mandible in rabbits. Active new bone formation comparable to that seen on HA implants was observed around the two compounds. The newly formed bone was in direct contact with the HA as well as the readily consolidated material and little adverse effect resulting from the glycolic acid and dextran was observed. Because the readily consolidating material was firm and could be contoured into any shape during the process of consolidation, it may be quite useful as a bone substitute and as an adherent for HA particles for reconstructive bone surgery, overcoming the disadvantages inherent to the particulate form of HA.

  10. Evaluation of a biodegradable graft substitute in rabbit bone defect model

    PubMed Central

    Yang, XiaoBo; Li, Yong; Huang, Qiang; Yang, Jing; Shen, Bing; Pei, FuXing

    2012-01-01

    Objective: To evaluate a new biodegradable copolymer calcium sulfate/poly amino acid (CS/PAA) as a graft substitute for the repair of the surgically created cancellous bone defects in rabbits and its biological properties in vivo. Materials and Methods: Cancellous bone defects were created by drilling holes in the unilateral lateral aspect of the femoral condyle of New Zealand white rabbits. Three groups were assigned: Group A rabbits were grafted with 80% CS/PAA and group B rabbits were grafted with 95% CS/PAA as two treatment groups; group C was sham-operation control group. To study the osteogenic capability in vivo, specimens were harvested at 4, 8, 12, and 16 weeks after implantation and were evaluated by gross assessment, X-ray, histological examination, and histomorphometry. In order to identify the molecular mechanism of bone defect repair, the expression of bone morphogenetic protein-2 (BMP-2) and vascular endothelial growth factor (VEGF) was detected using Western blot at 4 weeks. Results: Group A and group B showed more vigorous and rapid repair leading to regeneration of cancellous bone than sham-operation control group on gross observation, radiology, and histomorphometry. There was no significant difference between groups A and B. Morphological observation and histological examination showed that the copolymers degraded in sync with the new bone formation process. The expression of BMP-2 and VEGF in implantation groups was higher than that in control group by western blot. Conclusion: These findings demonstrated that the novel biodegradable copolymers can repair large areas of cancellous bone defects. With its controllable degradation rate, it suggests that CS/PAA may be a series of useful therapeutic substitute for bone defects. PMID:22719111

  11. Fusion rates after thoracoscopic release and bone graft substitutes in idiopathic scoliosis.

    PubMed

    Weinzapfel, Brett; Son-Hing, Jochen P; Armstrong, Douglas G; Blakemore, Laurel C; Poe-Kochert, Connie; Thompson, George H

    2008-05-01

    A retrospective assessment of fusion rates using either morselized allograft bone or demineralized bone matrix (DBM) following video-assisted thoracoscopic surgery (VATS) in idiopathic scoliosis. To compare fusion rates between allograft bone and demineralized bone matrix (Grafton DBM Flex) following VATS using on standard standing lateral spine radiographs. Both VATS and bone graft substitutes are accepted surgical techniques. However, their concomitant use in spinal deformity surgery has not been previously reported. Bone graft substitute has the advantage of decreasing operative time, blood loss, and donor site morbidity associated with autografts. Anterior thoracic discectomies were performed using VATS. Forty patients with 1 year or more follow-up were evaluated-12 with morselized allograft bone (Allograft group) and 28 with folded Grafton DBM Flex (DBM group). Factors analyzed included age, number of anterior levels fused, operative time, anterior perioperative blood loss, curve correction, and fusion rates. Clinical and radiographic evaluations were performed before surgery and at month, 1 year, and at most recent follow-up. Interbody fusion was assessed on standing lateral radiographs using the Newton et al 4-level grading scale. There were no significant differences in age at surgery, number of anterior vertebral levels fused, anterior operative time per level, anterior intraoperative blood loss, chest tube drainage and duration, or total perioperative anterior blood loss between the 2 groups. Percent curve correction from before surgery to the most recent follow-up were very similar in both Allograft (68%) and DBM groups (67%). At most recent assessment, 60 of 73 disc spaces (82%) in the Allograft group and 100 of 109 disc spaces (92%) in the DBM group were rated as radiographically fused (Newton et al Grade I and II). There was no significant difference between the 2 groups (P = 0.088). No patients were observed to have crankshaft, pseudoarthrosis or

  12. Computational Analysis of Artificial Gravity as a Possible Countermeasure to Spaceflight Induced Bone Loss

    NASA Technical Reports Server (NTRS)

    Mulugeta, L.; Werner, C. R.; Pennline, J. A.

    2015-01-01

    During exploration class missions, such as to asteroids and Mars, astronauts will be exposed to reduced gravity for extended periods. Data has shown that astronauts lose bone mass at a rate of 1% to 2% a month in microgravity, particularly in lower extremities such as the proximal femur. Exercise countermeasures have not completely eliminated bone loss from long duration spaceflight missions, which leaves astronauts susceptible to early onset osteoporosis and greater risk of fracture. Introduction of the Advanced Resistive Exercise Device and other large exercise devices on the International Space Station (ISS), coupled with improved nutrition, has further minimized bone loss. However, unlike the ISS, exploration vehicles will have very limited volume and power available to accommodate such capabilities. Therefore, novel concepts like artificial gravity systems are being explored as a means to provide sufficient load stimulus to the musculoskeletal system to mitigate bone changes that may lead to early onset osteoporosis and increased risk of fracture. Currently, there is minimal data available to drive further research and development efforts to appropriately explore such options. Computational modeling can be leveraged to gain insight on the level of osteoprotection that may be achieved using artificial gravity produced by a spinning spacecraft or centrifuge. With this in mind, NASA's Digital Astronaut Project (DAP) has developed a bone remodeling model that has been validated for predicting volumetric bone mineral density (vBMD) changes of trabecular and cortical bone both for gravitational unloading condition and the equivalent of 1g daily load stimulus. Using this model, it is possible to simulate vBMD changes in trabecular and cortical bone under different gravity conditions. In this presentation, we will discuss our preliminary findings regarding if and how artificial gravity may be used to mitigate spaceflight induced bone loss.

  13. Porous ceramics as bone graft substitutes in long bone defects: a biomechanical, histological, and radiographic analysis.

    PubMed

    Johnson, K D; Frierson, K E; Keller, T S; Cook, C; Scheinberg, R; Zerwekh, J; Meyers, L; Sciadini, M F

    1996-05-01

    Three porous ceramic bone graft materials were compared with regard to their ability to heal a 2.5 cm defect created surgically in a bilateral canine radius model. The ceramic materials were analyzed at 12 and 24 weeks after surgery and included tricalcium phosphate, hydroxyapatite, and collagen hydroxyapatite, which contained a mixture of 35% tricalcium phosphate and 65% hydroxyapatite with added collagen. Each material was evaluated alone and with added bone marrow aspirate. All the implants were compared with a graft of autogenous cancellous bone in the contralateral radius. Biomechanical testing and radiographic evaluation revealed that the addition of bone marrow aspirate was essential for tricalcium phosphate and hydroxyapatite to achieve results comparable with those of cancellous bone. Collagen hydroxyapatite performed well without the addition of bone marrow, although the addition of marrow did have a positive effect. Further qualitative radiographic and histological analysis demonstrated that tricalcium phosphate was the only ceramic that showed any sign of degradation at 24 weeks. This observed degradation proved to be an important factor in evaluating radiographs because the radiodensity of collagen hydroxyapatite and hydroxyapatite interfered with the determination of radiographic union. At 24 weeks, tricalcium phosphate with bone marrow was the material that performed most like cancellous bone. In this study, the biomechanical and radiographic parameters of tricalcium phosphate with bone marrow were roughly comparable with those of cancellous bone at 12 and 24 weeks. Tricalcium phosphate was the only implant that showed significant evidence of degradation at 24 weeks by both histological and radiographic evaluations, and this degradation took place only after a degree of mechanical competence necessary for weight-bearing was achieved.

  14. Artificial Gravity: Will it Preserve Bone Health on Long-Duration Missions?

    NASA Technical Reports Server (NTRS)

    Davis-Street, Janis; Paloski, William H.

    2005-01-01

    Prolonged microgravity exposure disrupts bone, muscle, and cardiovascular homeostasis, sensory-motor coordination, immune function, and behavioral performance. Bone loss, in particular, remains a serious impediment to the success of exploration-class missions by increasing the risks of bone fracture and renal stone formation for crew members. Current countermeasures, consisting primarily of resistive and aerobic exercise, have not yet proven fully successful for preventing bone loss during long-duration spaceflight. While other bone-specific countermeasures, such as pharmacological therapy and dietary modifications, are under consideration, countermeasure approaches that simultaneously address multiple physiologic systems may be more desirable for exploration-class missions, particularly if they can provide effective protection at reduced mission resource requirements (up-mass, power, crew time, etc). The most robust of the multi-system approaches under consideration, artificial gravity (AG), could prevent all of the microgravity-related physiological changes from occurring. The potential methods for realizing an artificial gravity countermeasure are reviewed, as well as selected animal and human studies evaluating the effects of artificial gravity on bone function. Future plans for the study of the multi-system effects of artificial gravity include a joint, cooperative international effort that will systematically seek an optimal prescription for intermittent AG to preserve bone, muscle, and cardiovascular function in human subjects deconditioned by 6 degree head-down-tilt-bed rest. It is concluded that AG has great promise as a multi-system countermeasure, but that further research is required to determine the appropriate parameters for implementation of such a countermeasure for exploration-class missions.

  15. Composite Based Chitosan/Zinc-Doped HA as a Candidate Material for Bone Substitute Applications

    NASA Astrophysics Data System (ADS)

    Wicaksono, S. T.; Rasyida, A.; Purnomo, A.; Pradita, N. N.; Ardhyananta, H.; Hidayat, M. I. P.

    2017-05-01

    The composite based Zinc-doped in Chitosan/Hydroxyapatite was successfully prepared by wet mixing method through the addition of 10, 15, and 20wt% of chitosan. The addition of Chitosan increased the compressive strength and the modulus elasticity. However, it decreased the density and the surface hardness of HA-Zn. Mechanical characterization revealed that these composites are suitable as a candidate of a cancellous bone substitute. Composite with 10% chitosan has compressive strength and modulus elasticity of 57.03 MPa and 0.15 GPa, respectively. Hence, it has the physical and mechanical properties that meet the standards as a cancellous bone substitute material. Also, in vitro biocompatibility test against BHK-21 cells exhibited non-toxic materials.

  16. Fabrication of Porous Hydroxyapatite Scaffolds as Artificial Bone Preform and its Biocompatibility Evaluation

    PubMed Central

    2014-01-01

    In this study, a novel porous hydroxyapatite scaffold was designed and fabricated to imitate natural bone through a multipass extrusion process. The conceptual design manifested unidirectional microchannels at the exterior part of the scaffold to facilitate rapid biomineralization and a central canal that houses the bone marrow. External and internal fissures were minimized during microwave sintering at 1,100°C. No deformation was noted, and a mechanically stable scaffold was fabricated. Detailed microstructure of the fabricated artificial bone was examined by scanning electron microscope and X-ray diffractometer, and material properties like compressive strength were evaluated. The initial biocompatibility was examined by the cell proliferation of MG-63 osteoblast-like cells using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. Preliminary in vivo investigation in a rabbit model after 4 weeks and 8 weeks of implantation showed full osteointegration of the scaffold with the native tissue, and formation of bone tissue within the pore network, as examined by microcomputed tomography analyses and histological staining. Osteon-like bone microarchitecture was observed along the unidirectional channel with microblood vessels. These confirm a biomimetic regeneration model in the implanted bone scaffold, which can be used as an artificial alternative for damaged bone. PMID:24399056

  17. Fusion in degenerative spondylolisthesis: comparison of osteoconductive and osteoinductive bone graft substitutes.

    PubMed

    Kurd, Mark; Cohick, Sarah; Park, Andrew; Ahmadinia, Kasra; Lee, Joseph; An, Howard

    2015-05-01

    The emergent widespread options of bone graft substitutes for spinal fusion procedures vary in their osteobiologic activity. A majority of current literature focuses on the comparison of osteoinductive (OI) or osteoconductive (OC) bone graft substitutes individually against ICBG. These studies have demonstrated the legitimacy of bone graft substitutes, but despite the widespread use in spinal fusion procedures there is a dearth in the current literature in the direct comparison of OC and OI substitutes. This retrospective comparative analysis compares the efficacy of OI vs. solely OC agents in producing radiographic fusion on patients with DS. Patients, who underwent a lumbar fusion for DS with at least 6 months post-op radiographs, were divided based on whether they received an OC or OI bone graft substitute. The OC groups included allografts, calcium phosphate, ceramics and hydroxyapatite products. The OI group included bone morphogenic protein, demineralized bone matrix, and stem cell-based products. Using a conservative hierarchical approach to determine fusion, fusion criteria included stringent use of multiple measurement methods including flexion/extension x-rays, Lenke and Brantigan CT fusion measurement criteria, and history of revision surgery due to pseudoarthrosis. A total of 126 patients (78 OI, 48 OC) met the studies inclusion criteria for the assessment for fusion. The mean time for flexion-extension radiographic evaluation was 13.1 months for the OI group and 15 months for the OC group. The mean time for CT scan evaluation was 18 months for the OI group and 15.9 months for the OC group. Using the stated hierarchical criteria for fusion stated above, the fusion rate for the OI group was 87.18%, and the fusion rate for the OC group was 93.75%. The difference in OI and OC groups was not statistically significant (P = 0.367). Based on the demographic data collected, there were no statistically significant factors determining fusion. With the vastly

  18. Improving the Clinical Evidence of Bone Graft Substitute Technology in Lumbar Spine Surgery

    PubMed Central

    Hsu, Wellington K.; Nickoli, M. S.; Wang, J. C.; Lieberman, J. R.; An, H. S.; Yoon, S. T.; Youssef, J. A.; Brodke, D. S.; McCullough, C. M.

    2012-01-01

    Bone graft substitutes have been used routinely for spine fusion for decades, yet clinical evidence establishing comparative data remains sparse. With recent scrutiny paid to the outcomes, complications, and costs associated with osteobiologics, a need to improve available data guiding efficacious use exists. We review the currently available clinical literature, studying the outcomes of various biologics in posterolateral lumbar spine fusion, and establish the need for a multicenter, independent osteobiologics registry. PMID:24353975

  19. 3D image analysis and artificial intelligence for bone disease classification.

    PubMed

    Akgundogdu, Abdurrahim; Jennane, Rachid; Aufort, Gabriel; Benhamou, Claude Laurent; Ucan, Osman Nuri

    2010-10-01

    In order to prevent bone fractures due to disease and ageing of the population, and to detect problems while still in their early stages, 3D bone micro architecture needs to be investigated and characterized. Here, we have developed various image processing and simulation techniques to investigate bone micro architecture and its mechanical stiffness. We have evaluated morphological, topological and mechanical bone features using artificial intelligence methods. A clinical study is carried out on two populations of arthritic and osteoporotic bone samples. The performances of Adaptive Neuro Fuzzy Inference System (ANFIS), Support Vector Machines (SVM) and Genetic Algorithm (GA) in classifying the different samples have been compared. Results show that the best separation success (100 %) is achieved with Genetic Algorithm.

  20. Paracrystalline Disorder from Phosphate Ion Orientation and Substitution in Synthetic Bone Mineral

    SciTech Connect

    Marisa, Mary E.; Zhou, Shiliang; Melot, Brent C.; Peaslee, Graham F.; Neilson, James R.

    2016-12-05

    Hydroxyapatite is an inorganic mineral closely resembling the mineral phase in bone. However, as a biological mineral, it is highly disordered, and its composition and atomistic structure remain poorly understood. Here, synchrotron X-ray total scattering and pair distribution function analysis methods provide insight into the nature of atomistic disorder in a synthetic bone mineral analogue, chemically substituted hydroxyapatite. By varying the effective hydrolysis rate and/or carbonate concentration during growth of the mineral, compounds with varied degrees of paracrystallinity are prepared. From advanced simulations constrained by the experimental pair distribution function and density functional theory, the paracrystalline disorder prevalent in these materials appears to result from accommodation of carbonate in the lattice through random displacement of the phosphate groups. Though many substitution modalities are likely to occur in concert, the most predominant substitution places carbonate into the mirror plane of an ideal phosphate site. Understanding the mineralogical imperfections of a biologically analogous hydroxyapatite is important not only to potential bone grafting applications but also to biological mineralization processes themselves.

  1. Development of multi-substituted hydroxyapatite nanopowders as biomedical materials for bone tissue engineering applications.

    PubMed

    Baba Ismail, Yanny M; Wimpenny, Ian; Bretcanu, Oana; Dalgarno, Kenneth; El Haj, Alicia J

    2017-02-15

    Ionic substitutions have been proposed as a tool to control the functional behavior of synthetic hydroxyapatite (HA), particularly for Bone Tissue Engineering (BTE) applications. The effect of simultaneous substitution of different levels of carbonate (CO3 ) and silicon (Si) ions in the HA lattice was investigated. Furthermore, human bone marrow-derived mesenchymal stem cells (hMSCs) were cultured on multi-substituted HA (SiCHA) to determine if biomimetic chemical compositions were osteoconductive. Of the four different compositions investigates, SiCHA-1 (0.58wt% Si) and SiCHA-2 (0.45wt% Si) showed missing bands for CO3 and Si using FTIR analysis, indicating competition for occupation of the phosphate site in the HA lattice. 500°C was considered the most favourable calcination temperature as: (i) the powders produced possessed a similar amount of CO3 (2-8wt%) and Si (<1.0wt%) as present in native bone; and (ii) there was a minimal loss of CO3 and Si from the HA structure to the surroundings during calcination. Higher Si content in SiCHA-1 led to lower cell viability and at most hindered proliferation, but no toxicity effect occurred. While, lower Si content in SiCHA-2 showed the highest ALP/DNA ratio after 21 days culture with hMSCs, indicating that the powder may stimulate osteogenic behaviour to a greater extent than other powders. This article is protected by copyright. All rights reserved.

  2. A Modified Rabbit Ulna Defect Model for Evaluating Periosteal Substitutes in Bone Engineering: A Pilot Study

    PubMed Central

    El Backly, Rania M.; Chiapale, Danilo; Muraglia, Anita; Tromba, Giuliana; Ottonello, Chiara; Santolini, Federico; Cancedda, Ranieri; Mastrogiacomo, Maddalena

    2014-01-01

    The present work defines a modified critical size rabbit ulna defect model for bone regeneration in which a non-resorbable barrier membrane was used to separate the radius from the ulna to create a valid model for evaluation of tissue-engineered periosteal substitutes. Eight rabbits divided into two groups were used. Critical defects (15 mm) were made in the ulna completely eliminating periosteum. For group I, defects were filled with a nanohydroxyapatite poly(ester urethane) scaffold soaked in PBS and left as such (group Ia) or wrapped with a tissue-engineered periosteal substitute (group Ib). For group II, an expanded-polytetrafluoroethylene (e-PTFE) (GORE-TEX®) membrane was inserted around the radius then the defects received either scaffold alone (group IIa) or scaffold wrapped with periosteal substitute (group IIb). Animals were euthanized after 12–16 weeks, and bone regeneration was evaluated by radiography, computed microtomography (μCT), and histology. In the first group, we observed formation of radio-ulnar synostosis irrespective of the treatment. This was completely eliminated upon placement of the e-PTFE (GORE-TEX®) membrane in the second group of animals. In conclusion, modification of the model using a non-resorbable e-PTFE membrane to isolate the ulna from the radius was a valuable addition allowing for objective evaluation of the tissue-engineered periosteal substitute. PMID:25610828

  3. A modified rabbit ulna defect model for evaluating periosteal substitutes in bone engineering: a pilot study.

    PubMed

    El Backly, Rania M; Chiapale, Danilo; Muraglia, Anita; Tromba, Giuliana; Ottonello, Chiara; Santolini, Federico; Cancedda, Ranieri; Mastrogiacomo, Maddalena

    2014-01-01

    The present work defines a modified critical size rabbit ulna defect model for bone regeneration in which a non-resorbable barrier membrane was used to separate the radius from the ulna to create a valid model for evaluation of tissue-engineered periosteal substitutes. Eight rabbits divided into two groups were used. Critical defects (15 mm) were made in the ulna completely eliminating periosteum. For group I, defects were filled with a nanohydroxyapatite poly(ester urethane) scaffold soaked in PBS and left as such (group Ia) or wrapped with a tissue-engineered periosteal substitute (group Ib). For group II, an expanded-polytetrafluoroethylene (e-PTFE) (GORE-TEX(®)) membrane was inserted around the radius then the defects received either scaffold alone (group IIa) or scaffold wrapped with periosteal substitute (group IIb). Animals were euthanized after 12-16 weeks, and bone regeneration was evaluated by radiography, computed microtomography (μCT), and histology. In the first group, we observed formation of radio-ulnar synostosis irrespective of the treatment. This was completely eliminated upon placement of the e-PTFE (GORE-TEX(®)) membrane in the second group of animals. In conclusion, modification of the model using a non-resorbable e-PTFE membrane to isolate the ulna from the radius was a valuable addition allowing for objective evaluation of the tissue-engineered periosteal substitute.

  4. Calcium phosphate cements for bone substitution: chemistry, handling and mechanical properties.

    PubMed

    Zhang, Jingtao; Liu, Weizhen; Schnitzler, Verena; Tancret, Franck; Bouler, Jean-Michel

    2014-03-01

    Since their initial formulation in the 1980s, calcium phosphate cements (CPCs) have been increasingly used as bone substitutes. This article provides an overview on the chemistry, kinetics of setting and handling properties (setting time, cohesion and injectability) of CPCs for bone substitution, with a focus on their mechanical properties. Many processing parameters, such as particle size, composition of cement reactants and additives, can be adjusted to control the setting process of CPCs, concomitantly influencing their handling and mechanical performance. Moreover, this review shows that, although the mechanical strength of CPCs is generally low, it is not a critical issue for their application for bone repair--an observation not often realized by researchers and clinicians. CPCs with compressive strengths comparable to those of cortical bones can be produced through densification and/or homogenization of the cement matrix. The real limitation for CPCs appears to be their low fracture toughness and poor mechanical reliability (Weibull modulus), which have so far been only rarely studied.

  5. Three-Dimensional Assessment of Volumetric Changes in Sinuses Augmented with Two Different Bone Substitutes

    PubMed Central

    Karabuda, Z. Cuneyt

    2016-01-01

    Introduction. The bone volume of the posterior maxilla may not be appropriate for implant placement, due to factors such as pneumatized maxillary sinus. The purpose of this study was to evaluate the percentage of graft volume reduction following sinus floor elevation (SFE), with either slow resorbable bone substitute only or a composite of slow and fast resorbable bone substitutes, using cone beam computed tomography (CBCT). Materials and Methods. In this retrospective study, CBCT scans of SFE procedures were evaluated to determine the volume of grafted sinus with either deproteinized bovine bone (DBB) or a 2 : 1 mixture of biphasic calcium sulfate (CS) and DBB, as a composite. The volumetric changes of sinus augmentations were measured 2 weeks (V-I) and 6 months (V-II) after operation. Results. Thirty-three patients were included in this study. The average percentage volume reduction was 9.39 ± 3.01% and 17.65 ± 4.15% for DBB and composite grafts, respectively. A significant graft volume reduction was observed between V-I and V-II for both groups (p < 0.01). The DBB group exhibited significantly less volume reduction than the composite group (p < 0.01). Conclusions. Augmented sinus volume may change before implant placement. DBB offers greater volume stability during healing than composite grafts. PMID:27517044

  6. In vivo evaluation of resorbable bone graft substitutes in a rabbit tibial defect model.

    PubMed

    Stubbs, D; Deakin, M; Chapman-Sheath, P; Bruce, W; Debes, J; Gillies, R M; Walsh, W R

    2004-09-01

    Calcium sulfate as a bone graft substitute is rapidly resorbed in vivo releasing calcium ions but fails to provide long-term three-dimensional framework to support osteoconduction. The setting properties of calcium sulfate however allow it to be applied in a slurry form making it easier to handle and apply in different situations. This study examines the in vivo response of calcium sulfate alone and as a carrier for a coralline hydroxyapatite in an established bilateral corticocancellous defect model in rabbits. Defects were filled flush to the anterior cortex with a resorbable porous ceramic alone and in combination with calcium sulfate slurry, calcium sulfate slurry alone or calcium sulfate pellets and examined at time points up to 52 weeks. Specimens where assessed using Faxitron X-ray, light and electron microscopy. Calcium sulfate in either slurry or pellet form does indeed support new bone formation alone however, complete filling of the bone defect is not observed. Calcium sulfate in slurry form does however improve the surgical handling of particulate bone graft substitutes such as Pro Osteon 200 R, which remained as an osteoconductive scaffold for up to 52 weeks and may have played an important role in the ultimate closure of the cortical windows.

  7. In vivo evaluation of resorbable bone graft substitutes in mandibular sockets of the beagle.

    PubMed

    Shih, Tsai-Chin; Chang, Wei-Jen; Yang, Jen-Chang; Feng, Sheng-Wei; Lin, Che-Tong; Teng, Nai-Chia

    2012-10-01

    Hydroxyapatite (Ca(10)(PO(4))(6)(OH)(2)), with its high biocompatibility and good bioaffinity, stimulates osteoconduction and is slowly replaced by the host bone after implantation. However, clinical use of HA as a bone substitute has proved problematic. It is difficult to prevent dispersion of the HA granules and to mold the granules into the desired shape. Calcium sulfate as a bone graft substitute is rapidly resorbed in vivo releasing calcium ions, but fails to provide a long-term, three-dimensional framework to support osteoconduction. The setting properties of calcium sulfate, however, allow it to be applied in a slurry form, making it easier to handle and apply in different situations. This study examines the in vivo response of a (Hydroxyapatite, apatitic phase)/calcium sulfate dehydrate (CSD) composite using different ratios in the mandibular premolar sockets of the beagle. The HA (AP)/CSD composite materials prepared in ratios of 30/70, 50/50, and 70/30 were implanted into the mandibular premolar sockets for 5 and 10 weeks. The control socket was empty. The authors compared the radiographic properties and the changes in height and width of the mandibular premolar sockets in the beagle. The composite graft in the 30/70 ratio had the best ability to form new bones.

  8. Bone substitute biomedical material of multi-(amino acid) copolymer: in vitro degradation and biocompatibility.

    PubMed

    Li, Hong; Yan, Yonggang; Wei, Jie; Ma, Jian; Gong, Min; Luo, Xiaoman; Zhang, Yunfei

    2011-11-01

    Degradable polymers with good mechanical strength as bone repair biomaterials have been paid more attention in biomedical application. In this study, a multi-(amino acid) copolymer consisting of 6-aminocaproic acid and five natural amino acids was prepared by a reaction of acid-catalyzed condensation. The results revealed that the copolymer could be slowly degradable in Tris-HCl solution, and lost its initial weight of 31.9 wt% after immersion for 12 weeks, and the changes of pH value of Tris-HCl solution were in range from 6.9 to 7.4 during soaking. The compressive strength of the copolymer decreased from 107 to 68 MPa after immersion for 12 weeks. The proliferation and differentiation of MG-63 cells on the copolymer significantly increased with time, and the cells with normal phenotype extended and spread well on the copolymer surfaces. When the copolymer was implanted in muscle and bone defects of femoral cortex of dogs for 12 weeks, the histological evaluation confirmed that the copolymer exhibited excellent biocompatibility and more effective osteogenesis in vivo. When implanted into cortical bone defects of dogs, the copolymer could be combined directly with the natural bone without fibrous capsule tissue between implants and host bone. The results indicated that the multi-(amino acid) copolymer with sufficient strength, good biocompatibility and osteoconductivity had clinical potential for load-bearing bone repair or substitution.

  9. Porous hydroxyapatite as a bone graft substitute in maxillary augmentation. An histometric study.

    PubMed

    Holmes, R; Hagler, H

    1988-07-01

    A porous HA matrix, which is available for clinical use, was compared with split rib autografts after maxillary contour augmentation in 17 dogs. Specimens were retrieved at 3, 6, 12, 24 and 48 months and undecalcified sections were prepared for microscopy and histometry. The implant and graft cross sectional areas did not change with time, although mechanical trauma caused early changes in implant area in some specimens. In all implants, union with the maxillary cortex occurred along with substantial bone ingrowth. An area under the periosteum contained soft tissue ingrowth. In all grafts, except one, union also occurred. However, bone ingrowth into the cancellous spaces was not apparent, or minimal. The implant specimens were composed of 34.7% HA matrix, 23.9% bone and 41.3% soft tissue. The bone ingrowth remained permanent for the study duration. A 6.5% decrease in HA matrix occurred between the 24 and 48 month time intervals, suggesting the presence of microporous surface resorption. The graft specimens were composed of 55.8% bone and 44.2% non-mineralized tissue, without change over time. The similarity in mineralized tissue composition of the implants (58.6%) and grafts (55.8%) supported the thesis that a porous HA matrix can function as a bone graft substitute.

  10. Interfacial and biological properties of the gradient coating on polyamide substrate for bone substitute.

    PubMed

    Huang, Di; Niu, Lulu; Wei, Yan; Guo, Meiqing; Zuo, Yi; Zou, Qin; Hu, Yinchun; Chen, Weiyi; Li, Yubao

    2014-10-06

    Fabrication of bioactive and mechanical matched bone substitutes is crucial for clinical application in bone defects repair. In this study, nano-hydroxyapatite/polyamide (nHA/PA) composite was coated on injection-moulded PA by a chemical corrosion and phase-inversion technique. The shear strength, gradient composition and pore structure of the bioactive coating were characterized. Osteoblast-like MG63 cells were cultured on pure PA and composite-coated PA samples. The cells' adhesion, spread and proliferation were determined using MTT assay and microscopy. The results confirm that the samples with the nHA/PA composite coating have better cytocompatibility and have no negative effects on cells. To investigate the in vivo biocompatibility, both pure PA and composite-coated PA cylinders were implanted in the trochlea of rabbit femurs and studied histologically, and the bonding ability with bone were determined using push-out tests. The results show that composite-coated implants exhibit better biocompatibility and the shear strength of the composite-coated implants with host bone at 12 weeks can reach 3.49±0.42 MPa, which is significantly higher than that of pure PA implants. These results indicate that composite-coated PA implants have excellent biocompatibility and bonding abilities with host bone and they have the potential to be applied in repair of bone defects.

  11. Interfacial and biological properties of the gradient coating on polyamide substrate for bone substitute

    PubMed Central

    Huang, Di; Niu, Lulu; Wei, Yan; Guo, Meiqing; Zuo, Yi; Zou, Qin; Hu, Yinchun; Chen, Weiyi; Li, Yubao

    2014-01-01

    Fabrication of bioactive and mechanical matched bone substitutes is crucial for clinical application in bone defects repair. In this study, nano-hydroxyapatite/polyamide (nHA/PA) composite was coated on injection-moulded PA by a chemical corrosion and phase-inversion technique. The shear strength, gradient composition and pore structure of the bioactive coating were characterized. Osteoblast-like MG63 cells were cultured on pure PA and composite-coated PA samples. The cells' adhesion, spread and proliferation were determined using MTT assay and microscopy. The results confirm that the samples with the nHA/PA composite coating have better cytocompatibility and have no negative effects on cells. To investigate the in vivo biocompatibility, both pure PA and composite-coated PA cylinders were implanted in the trochlea of rabbit femurs and studied histologically, and the bonding ability with bone were determined using push-out tests. The results show that composite-coated implants exhibit better biocompatibility and the shear strength of the composite-coated implants with host bone at 12 weeks can reach 3.49 ± 0.42 MPa, which is significantly higher than that of pure PA implants. These results indicate that composite-coated PA implants have excellent biocompatibility and bonding abilities with host bone and they have the potential to be applied in repair of bone defects. PMID:25121648

  12. Nanocrystalline hydroxyapatite bone substitute leads to sufficient bone tissue formation already after 3 months: histological and histomorphometrical analysis 3 and 6 months following human sinus cavity augmentation.

    PubMed

    Ghanaati, Shahram; Barbeck, Mike; Willershausen, Ines; Thimm, Benjamin; Stuebinger, Stefan; Korzinskas, Tadas; Obreja, Karina; Landes, Constantin; Kirkpatrick, Charles J; Sader, Robert A

    2013-12-01

    In this study the de novo bone formation capacity of a nanocrystalline hydroxyapatite bone substitute was assessed 3 and 6 months after its insertion into the human sinus cavity. Sinus cavity augmentation was performed in a total of 14 patients (n = 7 implantation after 3 months; n = 7 implantation after 6 months) with severely atrophic maxillary bone. The specimens obtained after 3 and 6 months were analyzed histologically and histomorphometrically with special focus on bone metabolism within the residual bone and the augmented region. This study revealed that bone tissue formation started from the bone-biomaterial-interface and was directed into the most cranial parts of the augmented region. There was no statistically significant difference in new bone formation after 3 and 6 months (24.89 ± 10.22% vs 31.29 ± 2.29%), respectively. Within the limits of the present study and according to previously published data, implant insertion in regions augmented with this bone substitute material could be considered already after 3 months. Further clinical studies with bone substitute materials are necessary to validate these findings. © 2012 Wiley Periodicals, Inc.

  13. The creation of the artificial RING finger from the cross-brace zinc finger by {alpha}-helical region substitution

    SciTech Connect

    Miyamoto, Kazuhide; Togiya, Kayo

    2010-04-16

    The creation of the artificial RING finger as ubiquitin-ligating enzyme (E3) has been demonstrated. In this study, by the {alpha}-helical region substitution between the EL5 RING finger and the Williams-Beuren syndrome transcription factor (WSTF) PHD finger, the artificial E3 (WSTF PHD{sub R}ING finger) was newly created. The experiments of the chemical modification of residues Cys and the circular dichroism spectra revealed that the WSTF PHD{sub R}ING finger binds two zinc atoms and adopts the zinc-dependent ordered-structure. In the substrate-independent ubiquitination assay, the WSTF PHD{sub R}ING finger functions as E3 and was poly- or mono-ubiquitinated. The present strategy is very simple and convenient, and consequently it might be widely applicable to the creation of various artificial E3 RING fingers with the specific ubiquitin-conjugating enzyme (E2)-binding capability.

  14. Integra artificial skin in the management of severe tissue defects, including bone exposure, in injured children.

    PubMed

    Violas, Philippe; Abid, Abdelazis; Darodes, Philippe; Galinier, Philippe; de Gauzy, Jérome Sales; Cahuzac, Jean-Philippe

    2005-09-01

    A dermal substitute, Integra (Integra Neurosciences Implants SA, Sophia Antipolis, France) artificial skin, was used for wound management on three children with lower limb injuries in our institutions. In one case this biosynthetic material was applied directly to a bony surface (patella). This technique allows an early wound coverage and provides a satisfactory preparation for autograft. It can be a useful adjunct in the treatment of severe tissue defects in child limb injuries.

  15. Histological evaluation of an impacted bone graft substitute composed of a combination of mineralized and demineralized allograft in a sheep vertebral bone defect.

    PubMed

    Fujishiro, Takaaki; Bauer, Thomas W; Kobayashi, Naomi; Kobayashi, Hideo; Sunwoo, Moon Hae; Seim, Howard B; Turner, A Simon

    2007-09-01

    Demineralized bone matrix (DBMs) preparations are a potential alternative or supplement to autogenous bone graft, but many DBMs have not been adequately tested in clinically relevant animal models. The aim of current study was to compare the efficacy of a new bone graft substitute composed of a combination of mineralized and demineralized allograft, along with hyaluronic acid (AFT Bone Void Filler) with several other bone graft materials in a sheep vertebral bone void model. A drilled defect in the sheep vertebral body was filled with either the new DBM preparation, calcium sulfate (OsteoSet), autologous bone graft, or left empty. The sheep were euthanized after 6 or 12 weeks, and the defects were examined by histology and quantitative histomorphometry. The morphometry data were analyzed by one-way analysis of variance with the post hoc Tukey-Kramer test or the Student's t-test. All of the bone defects in the AFT DBM preparation group showed good new bone formation with variable amounts of residual DBM and mineralized bone graft. The DBM preparation group at 12 weeks contained significantly more new bone than the defects treated with calcium sulfate or left empty (respectively, p < 0.05, p < 0.01). There was no significant difference between the DBM and autograft groups. No adverse inflammatory reactions were associated with any of the three graft materials. The AFT preparation of a mixture of mineralized and demineralized allograft appears to be an effective autograft substitute as tested in this sheep vertebral bone void model.

  16. Does PRP enhance bone integration with grafts, graft substitutes, or implants? A systematic review

    PubMed Central

    2013-01-01

    Background Several bone implants are applied in clinical practice, but none meets the requirements of an ideal implant. Platelet-rich plasma (PRP) is an easy and inexpensive way to obtain growth factors in physiologic proportions that might favour the regenerative process. The aim of this review is to analyse clinical studies in order to investigate the role of PRP in favouring bone integration of graft, graft substitutes, or implants, and to identify the materials for which the additional use of PRP might be associated with superior osseo- and soft tissues integration. Methods A search on PubMed database was performed considering the literature from 2000 to 2012, using the following string: ("Bone Substitutes"[Mesh] OR "Bone Transplantation"[Mesh] OR "Bone Regeneration"[Mesh] OR "Osseointegration"[Mesh]) AND ("Blood Platelets"[Mesh] OR "Platelet-Rich Plasma"[Mesh]). After abstracts screening, the full-texts of selected papers were analyzed and the papers found from the reference lists were also considered. The search focused on clinical applications documented in studies in the English language: levels of evidence included in the literature analysis were I, II and III. Results Literature analysis showed 83 papers that fulfilled the inclusion criteria: 26 randomized controlled trials (RCT), 14 comparative studies, 29 case series, and 14 case reports. Several implant materials were identified: 24 papers on autologous bone, 6 on freeze-dried bone allograft (FDBA), 16 on bovine porous bone mineral (BPBM), 9 on β-tricalcium phosphate (β-TCP), 4 on hydroxyapatite (HA), 2 on titanium (Ti), 1 on natural coral, 1 on collagen sponge, 1 on medical-grade calcium sulphate hemihydrate (MGCSH), 1 on bioactive glass (BG) and 18 on a combination of biomaterials. Only 4 papers were related to the orthopaedic field, whereas the majority belonged to clinical applications in oral/maxillofacial surgery. Conclusions The systematic research showed a growing interest in this approach

  17. Improvement of osteogenic potential of biphasic calcium phosphate bone substitute coated with synthetic cell binding peptide sequences

    PubMed Central

    Choi, Hyunmin; Park, Nho-Jae; Jamiyandorj, Otgonbold; Hong, Min-Ho; Oh, Seunghan; Park, Young-Bum

    2012-01-01

    Purpose The aim of this study was to evaluate the improvement of osteogenic potential of biphasic calcium phosphate (BCP) bone substitute coated with synthetic cell-binding peptide sequences in a standardized rabbit sinus model. Methods Standardized 6-mm diameter defects were created bilaterally on the maxillary sinus of ten male New Zealand white rabbits, receiving BCP bone substitute coated with synthetic cell binding peptide sequences on one side (experimental group) and BCP bone substitute without coating (control group) on the other side. Histologic and histomorphometric analysis of bone formation was carried out after a healing period of 4 or 8 weeks. Results Histological analysis revealed signs of new bone formation in both experimental groups (4- and 8-week healing groups) with a statistically significant increase in bone formation in the 4-week healing group compared to the control group. However, no statistically significant difference in bone formation was found between the 8-week healing group and the control group. Conclusions This study found that BCP bone substitute coated with synthetic cell-binding peptide sequences enhanced osteoinductive potential in a standardized rabbit sinus model and its effectiveness was greater in the 4-week healing group than in the 8-week healing group. PMID:23185697

  18. Permeability of rapid prototyped artificial bone scaffold structures.

    PubMed

    Lipowiecki, Marcin; Ryvolová, Markéta; Töttösi, Ákos; Kolmer, Niels; Naher, Sumsun; Brennan, Stephen A; Vázquez, Mercedes; Brabazon, Dermot

    2014-11-01

    In this work, various three-dimensional (3D) scaffolds were produced via micro-stereolithography (µ-SLA) and 3D printing (3DP) techniques. This work demonstrates the advantages and disadvantages of these two different rapid prototyping methods for production of bone scaffolds. Compared to 3DP, SLA provides for smaller feature production with better dimensional resolution and accuracy. The permeability of these structures was evaluated experimentally and via numerical simulation utilizing a newly derived Kozeny-Carman based equation for intrinsic permeability. Both experimental and simulation studies took account of porosity percentage, pore size, and pore geometry. Porosity content was varied from 30% to 70%, pore size from 0.34 mm to 3 mm, and pore geometries of cubic and hexagonal closed packed were examined. Two different fluid viscosity levels of 1 mPa · s and 3.6 mPa · s were used. The experimental and theoretical results indicated that permeability increased when larger pore size, increased fluid viscosity, and higher percentage porosity were utilized, with highest to lowest degree of significance following the same order. Higher viscosity was found to result in permeabilities 2.2 to 3.3 times higher than for water. This latter result was found to be independent of pore morphology type. As well as demonstrating method for determining design parameters most beneficial for scaffold structure design, the results also illustrate how the variations in patient's blood viscosity can be extremely important in allowing for permeability through the bone and scaffold structures.

  19. Immunohistochemical characterization of wound healing at two different bone graft substitutes.

    PubMed

    Sager, M; Ferrari, D; Wieland, M; Dard, M; Becker, J; Schwarz, F

    2012-05-01

    The immunohistochemical characteristics of wound healing following application of a biphasic calcium phosphate or a collagen coated natural bone combined with a native collagen membrane in a dog model was assessed. Standardized buccal dehiscence-type defects were surgically created following implant bed preparation in 6 dogs. Following implant placement, defects were randomly filled with a collagen coated natural bone mineral (GBO), or a biphasic hydroxyapatite/beta tricalcium phosphate (SBC), and covered with a native collagen membrane. After 1, 4, and 9 weeks' submerged healing, dissected blocks were processed for immunohistochemical (collagen type I (CI), osteocalcin (OC), angiogenesis (TG)) analysis. At 1 week, GBO and SBC granules were homogeneously surrounded by a well vascularized, non-mineralized tissue (NMT). CI and OC antigen reactivity was commonly observed adjacent to both bone graft substitutes. At 4 and 9 weeks, SBC and GBO granules were completely integrated into a secondly formed network of spongiosa. At 9 weeks, dissolution of some granules was observed in the SBC group. Adjacent to these granules, NMT was significantly increased and revealed a pronounced CI, OC and TG antigen reactivity. The initial pattern of bone regeneration and graft integration was comparable in both groups; bone remodelling was more pronounced with SBC.

  20. Tantalum is a good bone graft substitute in tibial tubercle advancement

    PubMed Central

    Querales, Virginia; Jakowlew, Alexander; Murcia, Antonio; Ballester, Jorge

    2009-01-01

    Background Porous tantalum is reportedly a good substitute for structural bone graft in several applications. So far, its use has not been reported in tibial tuberosity anteriorization (TTA) for treatment of isolated degenerative chondral lesions of the patellofemoral joint. Questions/Purposes We asked whether the use of this material would produce similar standardized functional scores, pain (VAS), fusion rates, complications, and patient satisfaction to those for bone graft. Patients and Methods We performed a randomized, controlled trial in 101 patients (108 knees) scheduled for TTA comparing a porous tantalum implant (57 knees) with an autologous local tibial bone graft (51 knees). The minimum followup was 5 years (mean, 6.2 years; range, 5–8 years). Results At the last followup, clinical scores, fusion rates, and maintenance of the anteriorization either were better or similar for the TTA using the tantalum implant depending on the respective parameter. The operative technique was easier and shorter with the tantalum device. Complication and failure rates were greater using bone graft. Patient satisfaction was greater using the tantalum implant. Conclusions Porous tantalum provided a reasonable alternative to bone graft in TTA. Level of Evidence Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. PMID:19806411

  1. Osteofibrous Dysplasia managed with Extraperiosteal excision, Autologous free fibular graft and bone graft substitute

    PubMed Central

    Abraham, Vineet T; Marimuthu, Chandrasekaran; Subbaraj, Ravichandran; Rengarajan, Nandakumar

    2015-01-01

    Introduction: Osteofibrous Dysplasia is a rare benign self-limiting fibro-osseous lesion most commonly seen in the diaphysis of the tibia. Its incidence is reported to be 0.2% of all primary bone tumors. It occurs in the first two decades of life with a slight male preponderance. Surgical options include extra periosteal resection, autologous graft, limb lengthening procedures etc. There are no case reports mentioning the use of synthetic bone graft to fill the defect following extraperiosteal excision. Case Report: A 13 year old girl presented with pain and swelling of the (R) leg since 2 months following a trivial injury at school. Examination revealed a 5×3cm tender swelling on the anteromedial aspect of the middle third tibia. Radiographs and MRI, revealed an eccentric expansile lytic lesion, which was multilocular and was present at the junction of the metaphysis and diaphysis on the antero -medial aspect of tibia. The cortex had ballooned out and there was a possibility of an impending fracture. Biopsy was done which revealed osteofibrous dysplasia. We did an extraperiosteal excision of the lesion. To fill the cavity we harvested 10 cm of the contralateral fibula and since there was still space in the cavity, we packed bone graft substitute (hydroxyapatite crystals) into the defect. The surgical management of osteofibrous dysplasia is controversial. Various methods of treatment of such cases have been described in literature. The use of synthetic graft is an option in these patients as it reduces morbidity; and in our case we had good graft incorporation with this method. Conclusion: Extraperiosteal Excision of Osteofibrous dysplasia combined with autologous free fibular graft and bone graft substitute is a good surgical option to prevent recurrence and mange bone defects in this rare lesion. PMID:27299018

  2. Comparison of in vitro and in vivo bioactivity: cuttlefish-bone-derived hydroxyapatite and synthetic hydroxyapatite granules as a bone graft substitute.

    PubMed

    Kim, Beom-Su; Kang, Hyo Jin; Yang, Sun-Sik; Lee, Jun

    2014-04-01

    Bone reconstruction in clinical settings often requires bone substitutes. Hydroxyapatite (HAp) is a widely used bone substitute due to its osteoconductive properties and bone bonding ability. The aim of this study was to evaluate HAp granules derived from cuttlefish bone (CB-HAp) as a substitute biomaterial for bone grafts. In this study, HAp granules were prepared from raw CB by using a hydrothermal reaction. The formation of HAp from CB was confirmed by scanning electron microscopy and x-ray diffraction analysis. The bioactivity of the CB-HAp granules was evaluated both in vitro and in vivo. Our results show that CB-HAp is non-toxic and that CB-HAp granules supported improved cell adhesion, proliferation and differentiation compared to stoichiometric synthetic HAp granules. Furthermore, in vivo bone defect healing experiments show that the formation of bone with CB-HAp is higher than that with pure HAp. These results show that CB-HAp granules have excellent potential for use as a bone graft material.

  3. Extraction and amplification of nuclear and mitochondrial DNA from ancient and artificially aged bones.

    PubMed

    von Wurmb-Schwark, Nicole; Harbeck, Michaela; Wiesbrock, Urs; Schroeder, Inge; Ritz-Timme, Stefanie; Oehmichen, Manfred

    2003-03-01

    An experimental design is presented that simulates an accelerated process of DNA degradation in human bone tissues and thus provides a possibility for a systematic investigation of factors hampering DNA extraction and amplification. Equal sized slices of human femoral bones were incubated in 90 degrees C water for 2 h up to 30 days. DNA was extracted and subjected to a human specific Duplex polymerase chain reaction (PCR) and also to a Multiplex short tandem repeat (STR) PCR. Additionally 24 ancient bones representing different age periods were investigated in the same way. The results were compared to those from the artificially aged samples. After just 12 h of incubation, DNA is totally degraded, but still fully typable. After 36 h no reproducible amplification of DNA is possible. Using Multiplex PCR the DNA from artificially aged bones shows the typical STR pattern for ancient samples suggesting that the in vitro approach provides a useful and comparable method to elucidate the DNA degradation process in bones.

  4. Primary stability of implants placed at different angulations in artificial bone.

    PubMed

    Kashi, Ajay; Gupta, Bhumija; Malmstrom, Hans; Romanos, Georgios E

    2015-02-01

    The aim of this study was to evaluate the primary stability (PS) of titanium implants with a progressive thread design and more thread stability in the apical threads placed in artificial bone materials. A total of 120 implants were placed in commercially available polyurethane composite bone blocks. The angulations that were chosen to place the implants in bone types II and IV were 0, 10, and 20 degrees, respectively. The implant dimensions were 11 mm in length and 3.5 mm in diameter. Two clinicians placed all implants, and an independent examiner evaluated the PS using the Osstell (ISQ) and Periotest devices. The χ test was used to evaluate the statistical differences between the PS at different angulations. This study showed that there was a statistically significant difference (P = 0.02) of the PS values, when measured using the Periotest values, among all 3 angulations in both bone qualities. Tilted implants with 10 degrees, angulation had a better stability than conventionally placed implants. The PS of dental implants is higher for implants placed in type II when compared with type IV artificial bone. A higher stability was found for implants placed with 10-degree angulations.

  5. Fantastic plastic? Experimental evaluation of polyurethane bone substitutes as proxies for human bone in trauma simulations.

    PubMed

    Smith, Martin J; James, Stephen; Pover, Tim; Ball, Nina; Barnetson, Victoria; Foster, Bethany; Guy, Carl; Rickman, John; Walton, Virginia

    2015-09-01

    Recent years have seen steady improvements in the recognition and interpretation of violence related injuries in human skeletal remains. Such work has at times benefited from the involvement of biological anthropologists in forensic casework and has often relied upon comparison of documented examples with trauma observed in skeletal remains. In cases where no such example exists investigators must turn to experimentation. The selection of experimental samples is problematic as animal proxies may be too dissimilar to humans and human cadavers may be undesirable for a raft of reasons. The current article examines a third alternative in the form of polyurethane plates and spheres marketed as viable proxies for human bone in ballistic experiments. Through subjecting these samples to a range of impacts from both modern and archaic missile weapons it was established that such material generally responds similarly to bone on a broad, macroscopic scale but when examined in closer detail exhibits a range of dissimilarities that call for caution in extrapolating such results to real bone.

  6. Collagen immobilization of multi-layered BCP-ZrO2 bone substitutes to enhance bone formation

    NASA Astrophysics Data System (ADS)

    Linh, Nguyen Thuy Ba; Jang, Dong-Woo; Lee, Byong-Taek

    2015-08-01

    A porous microstructure of multi-layered BCP-ZrO2 bone substitutes was fabricated using the sponge replica method in which the highly interconnected structure was immobilized with collagen via ethyl(dimethylaminopropyl)carbodiimide/N-hydroxysuccinimide crosslinking. Their struts are combined with a three-layered BCP/BCP-ZrO2/ZrO2 microstructure. Collagen fibers were firmly attached to the strut surface of the BCP-ZrO2 scaffolds. With control of the three-layered microstructure and collagen immobilization, the compressive strength of the scaffolds increased significantly to 6.8 MPa compared to that of the monolithic BCP scaffolds (1.3 MPa). An in vitro study using MTT, confocal observation, and real-time polymer chain reaction analysis demonstrated that the proliferation and differentiation of the pre-osteoblast-like MC3T3-E1 cells was improved due to the collagen incorporation. Remarkable enhancement of bone regeneration was observed without any immunological reaction in the femurs of rabbits during 1 and 5 months of implantation. Furthermore, the interfaces between new bone and the scaffold struts bonded directly without any gaps.

  7. [Repair mechanisms of the wounds with exposed bone structures using an artificial dermis].

    PubMed

    Chen, X; Wang, C; Zhang, C; Huang, X; Cao, H S

    2017-01-24

    Objective: To investigate the repair mechanisms of the wounds with bone exposed by artificial dermis transplantation. Methods: Seventy two rabbits were randomly divided into 3 groups of 24 rabbits, the wound model was made on the top of head. In the skin defect group (SD group), skin was removed and skull periosteum was retained. In the periosteal defect group (PD group), the skin and skull periosteum were both removed, and the skull was exposed. In the skull burn group (SB group), after the periosteum was removed, the exposed skull bone was burned out with electric iron to cause skull surface necrosis, then the artificial dermis transplantation were performed in each group. In 1, 2, 3 and 4 weeks after transplantation, 2 specimens including artificial dermis and the underlying tissue in each group were cut for biopsy with HE staining to observe the angiogenesis in artificial dermis. Evans Blue perfusion was performed in four animals from each group to quantify angiogenesis in artificial dermis. Results: One week after transplantation, in SD group, a few microvessels can be observed in artificial dermis, but in the rest of the two groups, only a small amount of inflammatory cells can be seen. Two weeks after transplantation, in SD group, a large number of new blood vessels and fibroblasts can be seen filling in the artificial dermis, but angiogenesis delayed obviously in the PD and SB group. Three weeks after transplantation, the angiogenesis of artificial dermis in the PD and SB group accelerated obviously, and a thin layer of blood rich tissue membrane can be seen over the burned skull. The Evans Blue perfusion showed that the content of dye perfusion in the artificial dermis was closed to the peek value at 2 weeks after transplantation in the SD group, which was significantly higher than that in PD and SB group [(2 741±976) vs (1 039±590) and (403±209) μg/g, P<0.01]. Three weeks after transplantation, the content of Evans Blue in artificial dermis reached

  8. Enhanced osteoporotic bone regeneration by strontium-substituted calcium silicate bioactive ceramics.

    PubMed

    Lin, Kaili; Xia, Lunguo; Li, Haiyan; Jiang, Xinquan; Pan, Haobo; Xu, Yuanjin; Lu, William W; Zhang, Zhiyuan; Chang, Jiang

    2013-12-01

    The regeneration capacity of the osteoporotic bones is generally lower than that of the normal bones. Current methods of bone defect treatment for osteoporosis are not always satisfactory. Recent studies have shown that the silicate based biomaterials can stimulate osteogenesis and angiogenesis due to the silicon (Si) ions released from the materials, and enhance bone regeneration in vivo. Other studies showed that strontium (Sr) plays a distinct role on inhibiting bone resorption. Based on the hypothesis that the combination of Si and Sr may have synergetic effects on osteoporotic bone regeneration, the porous Sr-substituted calcium silicate (SrCS) ceramic scaffolds combining the functions of Sr and Si elements were developed with the goals to promote osteoporotic bone defect repair. The effects of the ionic extract from SrCS on osteogenic differentiation of bone marrow mesenchymal stem cells derived from ovariectomized rats (rBMSCs-OVX), angiogenic differentiation of human umbilical vein endothelial cells (HUVECs) were investigated. The in vitro results showed that Sr and Si ions released from SrCS enhanced cell viability, alkaline phosphatase (ALP) activity, and mRNA expression levels of osteoblast-related genes of rBMSCs-OVX and expression of vascular endothelial growth factor (VEGF) without addition of extra osteogenic and angiogenic reagents. The activation in extracellular signal-related kinases (ERK) and p38 signaling pathways were observed in rBMSCs-OVX cultured in the extract of SrCS, and these effects could be blocked by ERK inhibitor PD98059, and P38 inhibitor SB203580, respectively. Furthermore, the ionic extract of SrCS stimulated HUVECs proliferation, differentiation and angiogenesis process. The in vivo experiments revealed that SrCS dramatically stimulated bone regeneration and angiogenesis in a critical sized OVX calvarial defect model, and the enhanced bone regeneration might be attributed to the modulation of osteogenic differentiation of

  9. Tof-Sims Application for Evaluating the Atomic Structure of New Bone Substitute Material

    NASA Astrophysics Data System (ADS)

    Oteri, G.; Pisanom, M.; Cicciù, M.

    2016-05-01

    The aim of this experimental study is to evaluate, in vitro, the chemical composition and the micromorphological structure of a bone substitute material surface. This material is based on calcium triphosphate and hydroxyapatite microgranules. Some results of a preliminary surface study of the above mentioned bioceramic materials are reported. The study has been carried out by means of time-of-flight secondary ion mass spectrometry (TOF-SIMS), complemented by X-ray photoelectron spectrometry (XPS) measurements. Whereas XPS data supplies the average surface composition of the system, TOF-SIMS supplies laterally and depth resolved information on the sample. This preliminary study confirms the properties of osteoconduction and scaffold features of the material. Moreover, a possible osteoinductive capability could be due to the presence of surface micropores, which could help in the attraction of bone morphogenetic protein (BMP), thus promoting the osteogenesis.

  10. Physical and mechanical properties evaluation of Acropora palmata coralline species for bone substitution applications.

    PubMed

    Alvarez, K; Camero, S; Alarcón, M E; Rivas, A; González, G

    2002-05-01

    The search for ideal materials for bone substitution has been a challenge for many decades. Numerous natural and synthetic materials have been studied. For this application, exoskeletons of coral have been considered a good alternative given its tendency to resorption, biocompatibility and similarity to the mineral bone phase. Very few studies of these materials consider a detailed analysis of the structure-property relationship. The purpose of this work was to carry out the microstructural characterization of a coralline species named Acropora palmata and the determination of the mechanical and physico-chemical properties. Measurements of hardness, compressive strength, bulk density and apparent porosity were performed. From these results it was determined that this marine coral species could be an alternative xenograft due to its mechanical properties and osteoconductive nature.

  11. Formation of a calcium phosphate-rich layer on absorbable calcium carbonate bone graft substitutes.

    PubMed

    Damien, C J; Ricci, J L; Christel, P; Alexander, H; Patat, J L

    1994-08-01

    The use of natural coral as a bone graft substitute is common in Europe. However, the bone-coral bonding mechanism remains elusive. A rat subcutaneous model was used to demonstrate changes at the surface of resorbable calcium carbonate in the form of natural coral. Histological results indicated in vivo formation of a calcium phosphate (CaP)-rich layer on the surface of the coral confirmed by backscattered electron imaging and X-ray microanalysis. There appears to be a combination solution-mediated dissolution/cell-mediated degradation of the natural coral with subsequent surface conversion or precipitation. The end result is a CaP-rich layer on the coral. Though this layer has been observed previously, it was originally thought to be a histological artifact. This result is similar, however, to what is seen with Bioglass and glass ceramics and may also explain the good bonding of bone to hydroxyapatite. The fact that this layer is also present on natural coral after implantation in soft tissue sites may explain the intimate bone apposition observed when natural coral is placed in bony sites.

  12. Development and characterization of a bioglass/chitosan composite as an injectable bone substitute.

    PubMed

    Khoshakhlagh, Parastoo; Rabiee, Sayed Mahmood; Kiaee, Gita; Heidari, Pedram; Miri, Amir K; Moradi, Roshanak; Moztarzadeh, Fathollah; Ravarian, Roya

    2017-02-10

    SiO2-CaO-P2O5 based bioglass (BG) systems constitute a group of materials that have wide applications in bone implants. Chitosan (Cn) is a biocompatible and osteoconductive natural polymer that can promote wound healing. In this study, bioactivity of chitosan/bioglass (CnB) composites as minimally invasive bone regenerative materials was assessed both in vitro and in vivo. Injectability tests and scanning electron microscopy (SEM) results demonstrated the formation of uniform injectable paste-like composites using BG particles and Cn. Fourier transform infrared spectroscopy (FTIR) and SEM images confirmed hydroxyapatite deposition in vitro after incubation in simulated body fluid (SBF). Higher BG content in the composite correlated with increased human osteoblast proliferation. An in vivo study in a rat spinal fusion model confirmed that increasing the amount of BG improved osteoconductivity. Manual palpation, radiographic images and pathological assessments proved that the composites promote bone formation. Based on these data, the synthesized composites have a potential application in orthopedic and reconstructive surgeries as a minimally invasive bone substitute.

  13. Unexpected radiographic lucency following grafting of bone defects with calcium sulfate/tricalcium phosphate bone substitute.

    PubMed

    Auston, Darryl A; Feibert, Matthew; Craig, Tina; Damron, Timothy A

    2015-10-01

    To report the development of unexpected radiographic lucency (URL) corresponding to the use of a commercially available calcium sulfate/tricalcium phosphate composite used to treat benign osseous lesions. This is a retrospective comparative study of patients with and without URL after treatment with curettage and grafting with calcium sulfate/tricalcium phosphate. The charts of 87 patients meeting the inclusion criteria were reviewed for demographic, clinical, and radiographic data. The group with URL was compared to those with more typical patterns of graft incorporation. Thirteen of 87 cases (15%) showed URL. There was no difference with respect to the pathologic subtype, anatomic location, or specific bone for the presence of URL. Of patients with URL, one (7.7%) required reoperation and regrafting, whereas among patients without URL, five (6.7%) had clinical complications, with one requiring reoperation and regrafting, and one requiring radiofrequency ablation. The majority of patients treated with calcium sulfate/tricalcium phosphate cementing after curettage of low-grade bone lesions go on to uneventful healing in our series. In a minority of patients, URL occurs in lieu of the more typical pattern of centripetal incorporation. However, there is no increase in complications associated with URL. Based on these findings, patients should be informed of the possibility of this risk, although there appears to be little risk of clinically relevant adverse consequences. Physicians should be aware of this complication in order to avoid mistaking it for recurrence of the primary lesion.

  14. Biocompatibility of artificial bone based on vancomycin loaded mesoporous silica nanoparticles and calcium sulfate composites.

    PubMed

    Gu, Jisheng; Wang, Teng; Fan, Guoxin; Ma, Junhua; Hu, Wei; Cai, Xiaobing

    2016-04-01

    The aim of this study was to evaluate the in vitro and in vivo biocompatibility of artificial bone based on vancomycin loaded mesoporous silica nanoparticles and calcium sulfate composites. In vitro cytotoxicity tests by cholecystokinin octapeptide (CCK-8) assay showed that the 5%Van-MSN-CaSO4 and Van-CaSO4 bone cements were cytocompatible for mouse osteoblastic cell line MC3T3-E1. The microscopic observation confirmed that MC3T3-E1cells incubated with Van-CaSO4 group and 5%Van-MSN-CaSO4 group exhibited clear spindle-shaped changes, volume increase and maturation, showing that these cements supported adhesion of osteoblastic cells on their surfaces. In addition, the measurement of alkaline phosphatase activity revealed the osteoconductive property of these biomaterials. In order to assess in vivo biocompatibility, synthesized cements were implanted into the distal femur of twelve adult male and female New Zealand rabbits. After implantation in artificial defects of the distal femur, 5%Van-MSN-CaSO4 and Van-CaSO4 bone cements did not damage the function of main organs of rabbits. In addition, the Van-MSN-CaSO4 composite allowed complete repair of bone defects with new bone formation 3 months after implantation. These results show potential application of Van-MSN-CaSO4 composites as bone graft materials for the treatment of open fracture in human due to its mechanical, osteoconductive and potential sustained drug release characteristics and the absence of adverse effects on the body.

  15. Development and characterization of novel alginate-based hydrogels as vehicles for bone substitutes.

    PubMed

    Morais, D S; Rodrigues, M A; Silva, T I; Lopes, M A; Santos, M; Santos, J D; Botelho, C M

    2013-06-05

    In this work three different hydrogels were developed to associate, as vehicles, with the synthetic bone substitute GR-HAP. One based on an alginate matrix (Alg); a second on a mixture of alginate and chitosan (Alg/Ch); and a third on alginate and hyaluronate (Alg/HA), using Ca(2+) ions as cross-linking agents. The hydrogels, as well as the respective injectable bone substitutes (IBSs), were fully characterized from the physical-chemical point of view. Weight change studies proved that all hydrogels were able to swell and degrade within 72 h at pH 7.4 and 4.0, being Alg/HA the hydrogel with the highest degradation rate (80%). Rheology studies demonstrated that all hydrogels are non-Newtonian viscoelastic fluids, and injectability tests showed that IBSs presented low maximum extrusion forces, as well as quite stable average forces. In conclusion, the studied hydrogels present the necessary features to be successfully used as vehicles of GR-HAP, particularly the hydrogel Alg/HA. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Fabrication of gelatin-strontium substituted calcium phosphate scaffolds with unidirectional pores for bone tissue engineering.

    PubMed

    Wu, Yu-Chun; Lin, Wei-Yu; Yang, Chyun-Yu; Lee, Tzer-Min

    2015-03-01

    This study fabricated homogeneous gelatin-strontium substituted calcium phosphate composites via coprecipitation in a gelatin solution. Unidirectional porous scaffolds with an oriented microtubular structure were then manufactured using freeze-drying technology. The resulting structure and pore alignment were determined using scanning electron microscopy. The pore size were in the range of 200-400 μm, which is considered ideal for the engineering of bone tissue. The scaffolds were further characterized using energy dispersive spectroscopy, Fourier transform infrared spectroscopy, and X-ray diffraction. Hydroxyapatite was the main calcium phosphate compound in the scaffolds, with strontium incorporated into the crystal structure. The porosity of the scaffolds decreased with increasing concentration of calcium-phosphate. The compressive strength in the longitudinal direction was two to threefold higher than that observed in the transverse direction. Our results demonstrate that the composite scaffolds degraded by approximately 20 % after 5 weeks. Additionally, in vitro results reveal that the addition of strontium significantly increased human osteoblastic cells proliferation. Scaffolds containing strontium with a Sr-CaP/(gelatin + Sr-CaP) ratio of 50 % provided the most suitable environment for cell proliferation, particularly under dynamic culture conditions. This study demonstrates the considerable potential of composite scaffolds composed of gelatin-strontium-substituted calcium phosphate for applications in bone tissue engineering.

  17. Calcification of cartilage formed in vitro on calcium polyphosphate bone substitutes is regulated by inorganic polyphosphate.

    PubMed

    St-Pierre, Jean-Philippe; Pilliar, Robert M; Grynpas, Marc D; Kandel, Rita A

    2010-08-01

    A major challenge to the successful clinical application of bioengineered cartilage remains its integration to surrounding tissues upon implantation. One way to address this consists of generating biphasic constructs composed of articular cartilage formed in vitro on the top surface and integrated with the porous sub-surface of a bone substitute material - in the case of this study, calcium polyphosphate (CPP). To improve the mechanical integrity of the cartilage-bone substitute interface, attempts have been made to generate a zone of calcified cartilage (ZCC) within the CPP-cartilage interface, thereby mimicking the native joint architecture. The purpose of this work was to establish the effects of the degradation products of CPP on cartilage calcification in order to explain the observed positioning of a ZCC away from the interface junction. It was determined that polyphosphate released from the CPP accumulates within in vitro-grown cartilage and inhibits cartilage calcification in a concentration and chain length (i.e. molecular weight) dependent manner. It was found that this effect is transient as chondrocytes express exopolyphosphatases which hydrolyze polyphosphate to release orthophosphate. Hence, the generation of biphasic constructs with a properly located ZCC will require tailoring of CPP substrates with lower degradation rates or the upregulation of exopolyphosphatases by chondrocytes. Copyright 2010 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  18. Comparative, Histological and Histomorphometric Analysis of Three Anorganic Bovine Xenogenous Bone Substitutes: Bio-Oss, Bone-Fill and Gen-Ox Anorganic.

    PubMed

    Manfro, Rafael; Fonseca, Fabiano Silva; Bortoluzzi, Marcelo Carlos; Sendyk, Wilson Roberto

    2014-12-01

    Anorganic bovine xenogenous grafts show the best performance as bone substitutes in implantodontics. Bio-Oss is the world's most widely used and investigated anorganic bone substitute. This article compares two anorganic bovine bone substitutes (Bone-Fill and Gen-Ox anorganic) with Bio-Oss. Eight New Zealand rabbits were implanted with 4 titanium cylinders randomly filled with Bio-Oss, Bone-Fill, Gen-Ox anorganic or a blood clot. Four animals were sacrificed after 8 weeks; 12 weeks later, the remaining four were sacrificed. The contents of the cylinders were removed, cut and stained with HE before they were evaluated with an optical microscope. The samples were submitted to histomorphometry for analysis. The bone formation with Bio-Oss at 8 weeks was 8.43 mm(2); at 12 weeks, it was 9.32 mm(2). The bone formation with Bone-Fill at 8 weeks was 7.24 mm(2); at 12 weeks, it was 9.01 mm(2). The bone formation with Gen-Ox anorganic at 8 weeks was 2.78 mm(2); at 12 weeks, it was 3.02 mm(2). The bone formation with the blood clot at 8 weeks was 0.65 mm(2); at 12 weeks, it was 0.63 mm(2). Following this model, Bone-Fill was comparable to Bio-Oss and superior to Gen-Ox and blood clot.

  19. A new concept of gentamicin loaded HAP/TCP bone substitute for prophylactic action: in vitro release validation.

    PubMed

    Laurent, Frédéric; Bignon, Aurélien; Goldnadel, Jérémy; Chevalier, Jérome; Fantozzi, Gilbert; Viguier, Eric; Roger, Thierry; Boivin, Georges; Hartmann, Daniel

    2008-02-01

    Infections and their consequences are a considerable problem in orthopaedic surgery. Despite intravenous prophylactic antibiotic administration, infection rates can reach in some occasions more than 1%. Indeed, the concentration in bone tissues is very low with the majority of antibiotics. Because high local dose can be obtained, the local release of gentamicin from acrylic bone cements has been shown to be efficient in preventing infections. However, for surgical procedures other than cemented prostheses no other local antibiotic releasing device is clinically available. The purpose of this study was to validate the concept of a gentamicin loaded bone substitute. About 125 mg of gentamicin were introduced into a HAP/TCP bone substitute for prophylactic purpose, to enhance the efficiency of systemic antibiotic treatments. The release rate of gentamicin from the bone substitute was investigated in vitro, in 0.9% sodium chloride solution. The rate appeared to be related to the bone substitute volume. All the gentamicin was released in less than 48 h. This release rate corresponds to the recommendations for the prophylactic use of antibiotics: the duration of the treatment should be less than 48 h, not to select antibiotic-resistant bacterial strains.

  20. Implantation of Thickened Artificial Bone for Reduction of Dead Space and Prevention of Infection Between Implant and Dura in Secondary Reconstruction of the Skull.

    PubMed

    Ozaki, Mine; Narita, Keigo; Kurita, Masakazu; Iwashina, Yuki; Takushima, Akihiko; Harii, Kiyonori

    2017-02-15

    For the treatment of skull defect compensation after neurosurgery, a customized artificial bone is often employed owing to its toughness and the relative ease of producing cosmetically good result. However, implants are vulnerable to infection and removal of implant is sometimes necessary. Several other treatment options such as autologous bone graft or free flap are likely to be considered for the secondary reconstruction to avoid reinfection; however, reimplantation of artificial bone is beneficial for the patients, being not concerned with donor site morbidity. The authors consider one of risk factors of infection of artificial bone as dead space between the implant and dura. To attain reduction of the dead space, we have employed thickened artificial bone.Between 2010 and 2014, 6 patients underwent implantation of thickened artificial bone for the secondary reconstruction.First, the infected artificial material was removed with proper debridement. More than 3 months after the closure of the infected wound, tissue expander was inserted beneath the surrounding scalp to ensure the coverage of subsequently implanted artificial bone without skin tension. The thickened artificial bone was designed from the computed tomography findings so as not to leave any dead space between the implant and dura. After optimal expansion of the scalp, the artificial bone was implanted.Postoperative courses were uneventful and the appearance of the cranial vault was satisfactory in all patients.The authors consider the use of the thickened artificial bone is easier and more suitable for patients having a skull defect, particularly in secondary reconstruction.

  1. Bone Marrow Stem/Progenitor Cells Attenuate the Inflammatory Milieu Following Substitution Urethroplasty

    PubMed Central

    Liu, Joceline S.; Bury, Matthew I.; Fuller, Natalie J.; Sturm, Renea M.; Ahmad, Nida; Sharma, Arun K.

    2016-01-01

    Substitution urethroplasty for the treatment of male stricture disease is often accompanied by subsequent tissue fibrosis and secondary stricture formation. Patients with pre-existing morbidities are often at increased risk of urethral stricture recurrence brought upon in-part by delayed vascularization accompanied by overactive inflammatory responses following surgery. Within the context of this study, we demonstrate the functional utility of a cell/scaffold composite graft comprised of human bone marrow-derived mesenchymal stem cells (MSC) combined with CD34+ hematopoietic stem/progenitor cells (HSPC) to modulate inflammation and wound healing in a rodent model of substitution urethroplasty. Composite grafts demonstrated potent anti-inflammatory effects with regards to tissue macrophage and neutrophil density following urethral tissue analyses. This was accompanied by a significant reduction in pro-inflammatory cytokines TNFα and IL-1β and further resulted in an earlier transition to tissue remodeling and maturation with a shift in collagen type III to I. Grafted animals demonstrated a progressive maturation and increase in vessel size compared to control animals. Overall, MSC/CD34+ HSPC composite grafts reduce inflammation, enhance an earlier transition to wound remodeling and maturation concurrently increasing neovascularization in the periurethral tissue. We demonstrate the feasibility and efficacy of a stem cell-seeded synthetic graft in a rodent substitution urethroplasty model. PMID:27762304

  2. Vacuum-sintered body of a novel apatite for artificial bone

    NASA Astrophysics Data System (ADS)

    Tamura, Kenichi; Fujita, Tatsushi; Morisaki, Yuriko

    2013-12-01

    We produced regenerative artificial bone material and bone parts using vacuum-sintered bodies of a novel apatite called "Titanium medical apatite (TMA®)" for biomedical applications. TMA was formed by chemically connecting a Ti oxide molecule with the reactive [Ca10(PO4)6] group of Hydroxyapatite (HAp). The TMA powders were kneaded with distilled water, and solid cylinders of compacted TMA were made by compression molding at 10 MPa using a stainless-steel vessel. The TMA compacts were dried and then sintered in vacuum (about 10-3 Pa) or in air using a resistance heating furnace in the temperature range 1073-1773 K. TMA compacts were sintered at temperatures greater than 1073 K, thus resulting in recrystallization. The TMA compact bodies sintered in the range 1273-1773 K were converted into mixtures composed of three crystalline materials: α-TCP (tricalcium phosphate), β-TCP, and Perovskite-CaTiO3. The Perovskite crystals were stable and hard. In vacuum-sintering, the Perovskite crystals were transformed into fibers (approximately 1 µm in diameter × 8 µm in length), and the fiber distribution was uniform in various directions. We refer to the TMA vacuum-sintered bodies as a "reinforced composite material with Perovskite crystal fibers." However, in atmospheric sintering, the Perovskite crystals were of various sizes and were irregularly distributed as a result of the effect of oxygen. After sintering temperature at 1573 K, the following results were obtained: the obtained TMA vacuum-sintered bodies (1) were white, (2) had a density of approximately 2300 kg/m3 (corresponding to that of a compact bone or a tooth), and had a thermal conductivity of approximately 31.3 W/(m·K) (corresponding to those of metal or ceramic implants). Further, it was possible to cut the TMA bodies into various forms with a cutting machine. An implant made of TMA and inserted into a rabbit jaw bone was covered by new bone tissues after just one month because of the high

  3. Bioactive glass incorporation in calcium phosphate cement-based injectable bone substitute for improved in vitro biocompatibility and in vivo bone regeneration.

    PubMed

    Sadiasa, Alexander; Sarkar, Swapan Kumar; Franco, Rose Ann; Min, Young Ki; Lee, Byong Taek

    2014-01-01

    In this work, we fabricated injectable bone substitutes modified with the addition of bioactive glass powders synthesized via ultrasonic energy-assisted hydrothermal method to the calcium phosphate-based bone cement to improve its biocompatibility. The injectable bone substitutes was initially composed of a powder component (tetracalcium phosphate, dicalcium phosphate dihydrate and calcium sulfate dehydrate) and a liquid component (citric acid, chitosan and hydroxyl-propyl-methyl-cellulose) upon which various concentrations of bioactive glass were added: 0%, 10%, 20% and 30%. Setting time and compressive strength of the injectable bone substitutes were evaluated and observed to improve with the increase of bioactive glass content. Surface morphologies were observed via scanning electron microscope before and after submersion of the samples to simulated body fluid and increase in apatite formation was detected using x-ray diffraction machine. In vitro biocompatibility of the injectable bone substitutes was observed to improve with the addition of bioactive glass as the proliferation/adhesion behavior of cells on the material increased. Human gene markers were successfully expressed using real time-polymerase chain reaction and the samples were found to promote cell viability and be more biocompatible as the concentration of bioactive glass increases. In vivo biocompatibility of the samples containing 0% and 30% bioactive glass were evaluated using Micro-CT and histological staining after 3 months of implantation in male rabbits' femurs. No inflammatory reaction was observed and significant bone formation was promoted by the addition of bioactive glass to the injectable bone substitute system.

  4. Small-sized granules of biphasic bone substitutes support fast implant bed vascularization

    PubMed Central

    Barbeck, M; Dard, M; Kokkinopoulou, M; Markl, J; Booms, P; Sader, RA; Kirkpatrick, CJ; Ghanaati, S

    2015-01-01

    The present study investigated the influence of granule size of 2 biphasic bone substitutes (BoneCeramic® 400–700 μm and 500–1000 μm) on the induction of multinucleated giant cells (MNGCs) and implant bed vascularization in a subcutaneous implantation model in rats. Furthermore, degradation mechanisms and particle phagocytosis of both materials were examined by transmission electron microscopy (TEM). Both granule types induced tissue reactions involving primarily mononuclear cells and only small numbers of MNGCs. Higher numbers of MNGCs were detected in the group with small granules starting on day 30, while higher vascularization was observed only at day 10 in this group. TEM analysis revealed that both mono- and multinucleated cells were involved in the phagocytosis of the materials. Additionally, the results allowed recognition of the MNGCs as the foreign body giant cell phenotype. Histomorphometrical analysis of the size of phagocytosed particles showed no differences between the 2 granule types. The results indicate that granule size seems to have impact on early implant bed vascularization and also on the induction of MNGCs in the late phase of the tissue reaction. Furthermore, the results revealed that a synthetic bone substitute material can induce tissue reactions similar to those of some xenogeneic materials, thus pointing to a need to elucidate their “ideal” physical characteristics. The results also show that granule size in the range studied did not alter phagocytosis by mononuclear cells. Finally, the investigation substantiates the differentiation of material-induced MNGCs, which are of the foreign body giant cell type. PMID:26083163

  5. Artificial Cells, Blood Substitutes, and Immobilization Biotechnology. Volume 22, Number 3, 1994.

    DTIC Science & Technology

    1994-05-01

    culture, microorganisms, enzymes, drugs, receptors, sorbents, immunosorbents and other biologically active molecules. (2) Artificial cells, microcapsules ...recombinant hemoglobin, and others. Chemistry, methods, in-vitro studies, in-vivo evaluations and clinical results. (4) Microencapsulation and other

  6. Artificial Cells, Blood Substitutes, and Immobilization Biotechnology. Volume 22 Number 2, 1994.

    DTIC Science & Technology

    1994-05-01

    culture, microorganisms, enzymes, drugs, receptors, sorbents, immunosorbents and other biologically active molecules. (2) Artificial cells, microcapsules ...recombinant hemoglobin, and others. Chemistry, methods, in-vitro studies, in-vivo evaluations and clinical results. (4) Microencapsulation and other

  7. Artificial Cells, Blood Substitutes, and Immobilization Biotechnology, Volume 22 Number 4, 1994.

    DTIC Science & Technology

    1994-01-01

    culture, microorganisms, enzymes, drugs, receptors, sorbents, immunosorbents and other biologically active molecules. (2) Artificial cells, microcapsules ...recombinant hemoglobin, and others. Chemistry, methods, in-vitro studies, in-vivo evaluations and clinical results. (4) Microencapsulation and other

  8. Characterisation of β-tricalcium phosphate-based bone substitute materials by electron paramagnetic resonance spectroscopy

    NASA Astrophysics Data System (ADS)

    Matković, Ivo; Maltar-Strmečki, Nadica; Babić-Ivančić, Vesna; Dutour Sikirić, Maja; Noethig-Laslo, Vesna

    2012-10-01

    β-TCP based materials are frequently used as dental implants. Due to their resorption in the body and direct contact with tissues, in order to inactivate bacteria, fungal spores and viruses, they are usually sterilized by γ-irradiation. However, the current literature provides little information about effects of the γ-irradiation on the formation and stability of the free radicals in the bone graft materials during and after sterilization procedure. In this work five different bone graft substitution materials, composed of synthetic beta tricalcium phosphate (β-TCP) and hydroxyapatite (HAP) present in the market were characterized by electron paramagnetic resonance (EPR) spectroscopy, X-ray powder diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and thermogravimetric analysis (TGA). Paramagnetic species Mn2+, Fe3+, trapped H-atoms and CO2- radicals were detected in the biphasic material (60% HAP, 40% β-TCP), while in β-TCP materials only Mn2+ andor trapped hydrogen atoms were detected. EPR analysis revealed the details of the structure of these materials at the atomic level. The results have shown that EPR spectroscopy is a method which can be used to improve the quality control of bone graft materials after syntering, processing and sterilization procedure.

  9. Effects of zinc-substituted nano-hydroxyapatite coatings on bone integration with implant surfaces*

    PubMed Central

    Zhao, Shi-fang; Dong, Wen-jing; Jiang, Qiao-hong; He, Fu-ming; Wang, Xiao-xiang; Yang, Guo-li

    2013-01-01

    Objective: The purpose of this study was to investigate the effects of a zinc-substituted nano-hydroxyapatite (Zn-HA) coating, applied by an electrochemical process, on implant osseointegraton in a rabbit model. Methods: A Zn-HA coating or an HA coating was deposited using an electrochemical process. Surface morphology was examined using field-emission scanning electron microscopy. The crystal structure and chemical composition of the coatings were examined using an X-ray diffractometer (XRD) and Fourier transform infrared spectroscopy (FTIR). A total of 78 implants were inserted into femurs and tibias of rabbits. After two, four, and eight weeks, femurs and tibias were retrieved and prepared for histomorphometric evaluation and removal torque (RTQ) tests. Results: Rod-like HA crystals appeared on both implant surfaces. The dimensions of the Zn-HA crystals seemed to be smaller than those of HA. XRD patterns showed that the peaks of both coatings matched well with standard HA patterns. FTIR spectra showed that both coatings consisted of HA crystals. The Zn-HA coating significantly improved the bone area within all threads after four and eight weeks (P<0.05), the bone to implant contact (BIC) at four weeks (P<0.05), and RTQ values after four and eight weeks (P<0.05). Conclusions: The study showed that an electrochemically deposited Zn-HA coating has potential for improving bone integration with an implant surface. PMID:23733429

  10. Application of K/Sr co-doped calcium polyphosphate bioceramic as scaffolds for bone substitutes.

    PubMed

    Xie, Huixu; Wang, Qianbin; Ye, Qingsong; Wan, Changxiu; Li, Longjiang

    2012-04-01

    Ion doping is one of the most important methods to modify the properties of bioceramics for better biodegrade abilities, biomechanical properties, and biocompatibilities. This paper presents a novel ion doping method applied in calcium polyphosphate (CPP)-based bioceramic scaffolds substituted by potassium and strontium ions (K/Sr) to form (K/Sr-CPP) scaffolds for bone tissue regeneration. The microstructure and crystallization of the scaffolds were detected by scanning electron microscopy and X-ray diffraction. Compressive strength and degradation tests were assessed to evaluate the mechanical and chemical stabilities of K/Sr-CPP in vitro. The cell biocompatibility was measured with respect to the cytotoxicity of the extractions of scaffolds. Muscle pouches and bone implantation were performed to evaluate the biodegradability and osteoconductivity of the scaffolds. The results indicated that the obtained K/Sr-CPP scaffolds had a single beta-CPP phase. The unit cell volume and average grain size increased but the crystallization decreased after the ions were doped into the CPP structure. The K/Sr-CPP scaffolds yielded a higher compressive strength and a better degradation property than the pure CPP scaffold. The MTT assay and in vivo results reveal that the K/Sr-CPP scaffolds exhibited a better cell biocompatibility and a tissue biocompatibility than CPP and hydroxyapatite scaffolds. This study proves the potential applications of K/Sr-CPP scaffolds in bone repair.

  11. Design and optimization of a tissue-engineered bone graft substitute

    NASA Astrophysics Data System (ADS)

    Shimko, Daniel Andrew

    2004-12-01

    formulation, and scaffold material from all preceding studies were combined and a tissue-engineered bone graft was fabricated. The graft was exposed to long-term in vitro culture, and then mechanically evaluated to determine its clinical potential. The studies contained herein constitute the first steps in the conception and development of a viable tissue-engineered bone graft substitute and establish a solid scientific foundation for future in vivo experimentation utilizing this design.

  12. Effects of artificial gravity during bed rest on bone metabolism in humans

    PubMed Central

    Smith, S. M.; Zwart, S. R.; Heer, M. A.; Baecker, N.; Evans, H. J.; Feiveson, A. H.; Shackelford, L. C.; LeBlanc, A. D.

    2009-01-01

    We report results from a study designed to explore the utility of artificial gravity (AG) as a countermeasure to bone loss induced by microgravity simulation. After baseline testing, 15 male subjects underwent 21 days of 6° head-down bed rest to simulate the deconditioning associated with spaceflight. Eight of the subjects underwent 1 h of centrifugation (AG; 1 Gz at the heart, 2.5 Gz at the feet) each day for 21 days, whereas seven of the subjects served as untreated controls (Con). Blood and urine were collected before, during, and after bed rest for bone marker determinations. Bone mineral density (BMD) and bone mineral content (BMC) were determined by dual-energy X-ray absorptiometry and peripheral quantitative computerized tomography before and after bed rest. Urinary excretion of bone resorption markers increased during bed rest, but the AG and Con groups did not differ significantly. The same was true for serum C-telopeptide. During bed rest, bone alkaline phosphatase (ALP) and total ALP tended to be lower in the AG group (P = 0.08, P = 0.09). Neither BMC nor BMD changed significantly from the pre-bed rest period in AG or Con groups, and the two groups were not significantly different. However, when AG and Con data were combined, there was a significant (P < 0.05) effect of time for whole body total BMC and total hip and trochanter BMD. These data failed to demonstrate efficacy of this AG prescription to prevent the changes in bone metabolism observed during 3 wk of bed rest. PMID:19074572

  13. Effects of artificial gravity during bed rest on bone metabolism in humans.

    PubMed

    Smith, S M; Zwart, S R; Heer, M A; Baecker, N; Evans, H J; Feiveson, A H; Shackelford, L C; Leblanc, A D

    2009-07-01

    We report results from a study designed to explore the utility of artificial gravity (AG) as a countermeasure to bone loss induced by microgravity simulation. After baseline testing, 15 male subjects underwent 21 days of 6 degrees head-down bed rest to simulate the deconditioning associated with spaceflight. Eight of the subjects underwent 1 h of centrifugation (AG; 1 G(z) at the heart, 2.5 G(z) at the feet) each day for 21 days, whereas seven of the subjects served as untreated controls (Con). Blood and urine were collected before, during, and after bed rest for bone marker determinations. Bone mineral density (BMD) and bone mineral content (BMC) were determined by dual-energy X-ray absorptiometry and peripheral quantitative computerized tomography before and after bed rest. Urinary excretion of bone resorption markers increased during bed rest, but the AG and Con groups did not differ significantly. The same was true for serum C-telopeptide. During bed rest, bone alkaline phosphatase (ALP) and total ALP tended to be lower in the AG group (P = 0.08, P = 0.09). Neither BMC nor BMD changed significantly from the pre-bed rest period in AG or Con groups, and the two groups were not significantly different. However, when AG and Con data were combined, there was a significant (P < 0.05) effect of time for whole body total BMC and total hip and trochanter BMD. These data failed to demonstrate efficacy of this AG prescription to prevent the changes in bone metabolism observed during 3 wk of bed rest.

  14. Design, synthesis, and initial evaluation of D-glyceraldehyde crosslinked gelatin-hydroxyapatite as a potential bone graft substitute material

    NASA Astrophysics Data System (ADS)

    Florschutz, Anthony Vatroslav

    Utilization of bone grafts for the treatment of skeletal pathology is a common practice in orthopaedic, craniomaxillofacial, dental, and plastic surgery. Autogenous bone graft is the established archetype but has disadvantages including donor site morbidity, limited supply, and prolonging operative time. In order to avoid these and other issues, bone graft substitute materials are becoming increasingly prevalent among surgeons for reconstructing skeletal defects and arthrodesis applications. Bone graft substitutes are biomaterials, biologics, and guided tissue/bone regenerative devices that can be used alone or in combinations as supplements or alternatives to autogenous bone graft. There is a growing interest and trend to specialize graft substitutes for specific indications and although there is good rationale for this indication-specific approach, the development and utility of a more universal bone graft substitute may provide a better answer for patients and surgeons. The aim of the present research focuses on the design, synthesis, and initial evaluation of D-glyceraldehyde crosslinked gelatin-hydroxyapatite composites for potential use as a bone graft substitutes. After initial establishment of rational material design, gelatinhydroxyapatite scaffolds were fabricated with different gelatin:hydroxyapatite ratios and crosslinking concentrations. The synthesized scaffolds were subsequently evaluated on the basis of their swelling behavior, porosity, density, percent composition, mechanical properties, and morphology and further assessed with respect to cell-biomaterial interaction and biomineralization in vitro. Although none of the materials achieved mechanical properties suitable for structural graft applications, a reproducible material design and synthesis was achieved with properties recognized to facilitate bone formation. Select scaffold formulations as well as a subset of scaffolds loaded with recombinant human bone morphogenetic protein-2 were

  15. Optimising implant anchorage (augmentation) during fixation of osteoporotic fractures: is there a role for bone-graft substitutes?

    PubMed

    Larsson, Sune; Procter, Philip

    2011-09-01

    When stabilising a fracture the contact between the screw and the surrounding bone is crucial for mechanical strength. Through development of screws with new thread designs, as well as optimisation of other properties, improved screw purchase has been gained. Other alternatives to improve screw fixation in osteoporotic bone, as well as normal bone if needed, includes the use of various coatings on the screw that will induce a bonding between the implant surface and the bone implant, as well as application of drugs such as bisphosphonates locally in the screw hole to induce improved screw anchorage through their anticatabolic effect on the bone tissue. As failure of internal fixation of fractures in osteoporotic bone typically occurs through breakage of the bone that surrounds the implant, rather than the implant itself, an alternative strategy in osteoporotic bone can include augmentation of the bone around the screw. This is useful when screws alone are being used for fixation, as it will increase pull-out resistance, but also when conventional plates and screws are used. In angularly stable plate-screw systems, screw back-out is not a problem if the locking mechanism between the screws and the plate works. However, augmentation that will strengthen the bone around the screws can also be useful in conjunction with angle-stable plate-screw systems, as the augmentation will provide valuable support when subjected to loading that might cause cut-out. For many years conventional bone cement, polymethylmethacrylate (PMMA), has been used for augmentation, but due to side effects--including great difficulties if removal becomes necessary--the use of PMMA has never gained wide acceptance. With the introduction of bone substitutes, such as calcium phosphate cement, it has been shown that augmentation around screws can be achieved without the drawbacks seen with PMMA. When dealing with fixation of fractures in osteoporotic bone where screw stability might be inadequate, it

  16. Bioinspired Design of Polycaprolactone Composite Nanofibers as Artificial Bone Extracellular Matrix for Bone Regeneration Application.

    PubMed

    Gao, Xiang; Song, Jinlin; Zhang, Yancong; Xu, Xiao; Zhang, Siqi; Ji, Ping; Wei, Shicheng

    2016-10-07

    The design and development of functional biomimetic systems for programmed stem cell response is a field of topical interest. To mimic bone extracellular matrix, we present an innovative strategy for constructing drug-loaded composite nanofibrous scaffolds in this study, which could integrate multiple cues from calcium phosphate mineral, bioactive molecule, and highly ordered fiber topography for the control of stem cell fate. Briefly, inspired by mussel adhesion mechanism, a polydopamine (pDA)-templated nanohydroxyapatite (tHA) was synthesized and then surface-functionalized with bone morphogenetic protein-7-derived peptides via catechol chemistry. Afterward, the resulting peptide-loaded tHA (tHA/pep) particles were blended with polycaprolactone (PCL) solution to fabricate electrospun hybrid nanofibers with random and aligned orientation. Our research demonstrated that the bioactivity of grafted peptides was retained in composite nanofibers. Compared to controls, PCL-tHA/pep composite nanofibers showed improved cytocompatibility. Moreover, the incorporated tHA/pep particles in nanofibers could further facilitate osteogenic differentiation potential of human mesenchymal stem cells (hMSCs). More importantly, the aligned PCL-tHA/pep composite nanofibers showed more osteogenic activity than did randomly oriented counterparts, even under nonosteoinductive conditions, indicating excellent performance of biomimetic design in cell fate decision. After in vivo implantation, the PCL-tHA/pep composite nanofibers with highly ordered structure could significantly promote the regeneration of lamellar-like bones in a rat calvarial critical-sized defect. Accordingly, the presented strategy in our work could be applied for a wide range of potential applications in not only bone regeneration application but also pharmaceutical science.

  17. Application of artificial neural network for micro-crack and damage evaluation of bone.

    PubMed

    Hasan, M S; Faruque, A; Burr, D B

    1997-01-01

    This paper presents the reasoning and adaptive learning method of artificial neural network (ANN) for micro-crack assessment and damage accumulation due to stiffness loss of dog bone. The importance of using the alternative approach of ANN is that it avoids the complexity of modeling problems, overrides the consideration of simplified assumptions and can be developed directly from experimental data using adaptive learning mechanisms. The proposed artificial neural network model provides a relationship between microdamage accumulation, stiffness loss and number of fatigue cycles (Nf) to failure from an experimental study where stiffness loss and crack area (Cr.Ar., mm2/mm2) are evaluated. This preliminary study using ANN for microdamage evaluation shows that ANN accurately predicts the amount of damage accumulation from stiffness loss.

  18. The relationship between particle morphology and rheological properties in injectable nano-hydroxyapatite bone graft substitutes.

    PubMed

    Ryabenkova, Y; Pinnock, A; Quadros, P A; Goodchild, R L; Möbus, G; Crawford, A; Hatton, P V; Miller, C A

    2017-06-01

    Biomaterials composed of hydroxyapatite (HA) are currently used for the treatment of bone defects resulting from trauma or surgery. However, hydroxyapatite supplied in the form of a paste is considered a very convenient medical device compared to the materials where HA powder and liquid need to be mixed immediately prior to the bone treatment during surgery. In this study we have tested a series of hydroxyapatite (HA) pastes with varying microstructure and different rheological behaviour to evaluate their injectability and biocompatibility. The particle morphology and chemical composition were evaluated using HRTEM, XRD and FTIR. Two paste-types were compared, with the HA particles of both types being rod shaped with a range of sizes between 20 and 80nm while differing in the particle aspect ratio and the degree of roundness or sharpness. The pastes were composed of pure HA phase with low crystallinity. The rheological properties were evaluated and it was determined that the pastes behaved as shear-thinning, non-Newtonian liquids. The difference in viscosity and yield stress between the two pastes was investigated. Surprisingly, mixing of these pastes at different ratios did not alter viscosity in a linear manner, providing an opportunity to produce a specific viscosity by mixing the two materials with different characteristics. Biocompatibility studies suggested that there was no difference in vitro cell response to either paste for primary osteoblasts, bone marrow mesenchymal stromal cells, osteoblast-like cells, and fibroblast-like cells. This class of nanostructured biomaterial has significant potential for use as an injectable bone graft substitute where the properties may be tailored for different clinical indications. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Development of porous polyurethane/strontium-substituted hydroxyapatite composites for bone regeneration.

    PubMed

    Sariibrahimoglu, Kemal; Yang, Wanxun; Leeuwenburgh, Sander C G; Yang, Fang; Wolke, Joop G C; Zuo, Yi; Li, Yubao; Jansen, John A

    2015-06-01

    Polyurethane (PU) has been widely used for the biomedical applications but its potential for bone regeneration is limited due to its lack of osteoconductive properties. Strontium substituted hydroxyapatite (SrHA) particles, on the other hand, are known to exhibit a positive effect on bone formation. Therefore, the aim of this study was to (i) develop porous polyurethane scaffolds containing strontium SrHA nanoparticles (PU/SrHA) and (ii) compare their in vitro biological performance for applications in bone regeneration to PU scaffolds. SrHA and HA was synthesized using a conventional wet-chemical neutralization reaction at temperatures of 25, 50, and 80°C. Chemical analysis was performed by inductively coupled plasma-optical emission spectrometry. Synthesizing temperatures at 25 and at 50°C were selected for the composite preparation (abbreviated as HA-25, SrHA-25, HA-50, and SrHA-50, respectively). PU was synthesized from isophorone diisocyanate, polytetramethylene ether glycol, and 1,4-butanediol. Composite scaffolds were prepared by addition of HA or SrHA nanoparticles into PU scaffolds during polymer preparation. The results showed that the Sr content in HA nanoparticles increased with increasing synthesis temperature. The addition of nanoparticles decreased the elongation-at-break and tensile strength, but significantly increased the surface wettability of the PU scaffolds. In vitro degradation tests demonstrated that release of cations was significantly higher from PU/SrHA-50 composite scaffolds. Cell culture tests indicated that PU composites containing either HA or SrHA nanoparticles increased proliferation of bone marrow stem cells as compared to plain PU scaffolds, whereas osteogenic differentiation was not affected by the incorporation of HA nanoparticles irrespective of the incorporation of Sr.

  20. Tailoring the degradation and biological response of a magnesium-strontium alloy for potential bone substitute application.

    PubMed

    Han, Junjie; Wan, Peng; Ge, Ye; Fan, Xinmin; Tan, Lili; Li, Jianjun; Yang, Ke

    2016-01-01

    Bone defects are very challenging in orthopedic practice. There are many practical and clinical shortcomings in the repair of the defect by using autografts, allografts or xenografts, which continue to motivate the search for better alternatives. The ideal bone grafts should provide mechanical support, fill osseous voids and enhance the bone healing. Biodegradable magnesium-strontium (Mg-Sr) alloys demonstrate good biocompatibility and osteoconductive properties, which are promising biomaterials for bone substitutes. The aim of this study was to evaluate and pair the degradation of Mg-Sr alloys for grafting with their clinical demands. The microstructure and performance of Mg-Sr alloys, in vitro degradation and biological properties including in vitro cytocompatibility and in vivo implantation were investigated. The results showed that the as-cast Mg-Sr alloy exhibited a rapid degradation rate compared with the as-extruded alloy due to the intergranular distribution of the second phase and micro-galvanic corrosion. However, the initial degradation could be tailored by the coating protection, which was proved to be cytocompatible and also suitable for bone repair observed by in vivo implantation. The integrated fracture calluses were formed and bridged the fracture gap without gas bubble accumulation, meanwhile the substitutes simultaneously degraded. In conclusion, the as-cast Mg-Sr alloy with coating is potential to be used for bone substitute alternative.

  1. Limitation of the antibiotic-eluting bone graft substitute: An example of gentamycin-impregnated calcium sulfate.

    PubMed

    Wu, Chang-Chin; Huang, Yang-Kai; Chang, Wei-Jen; Wu, Yun-Ching; Wang, Chen-Chie; Yang, Kai-Chiang

    2016-11-18

    Patients with inadequate volume of alveolar processes or bone defects commonly require graft substitutes in oral, maxillofacial or orthopedic surgery. Ridge augmentation and reconstruction of facial bony defects with bone graft materials achieve better outcomes in functional and aesthetic rehabilitation. The injectable calcium sulfate filler is used widely in intra-operative applications. Calcium sulfate bone filler has been shown to upregulate bone formation-related mRNA genes in vitro and improve osseointegration in vivo. In addition, the bone graft substitute can be used as a drug delivery system for antibiotics to treat or prevent infections based on the clinical experiences. However, the influences of antibiotics addition on the calcium sulfate are not fully understood. In this study, calcium sulfate impregnated with gentamycin in different weight ratios was characterized. The results showed that gentamycin prolonged the hydration process and extended initial/final setting times of calcium sulfate. The addition of gentamycin slowed the conversion from calcium sulfate hemihydrate to dihydrate and changed the crystalline phase and microstructure. Higher amounts of gentamycin added resulted in faster degradation and lower mechanical strength of calcium sulfate. This study reveals that the extended setting time, decreased compressive strength, and the accelerated degradation of the gentamycin-impregnated calcium sulfate bone graft substitutes should be considered during intra-operative applications. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2016. © 2016 Wiley Periodicals, Inc.

  2. Implantation of silicon dioxide-based nanocrystalline hydroxyapatite and pure phase beta-tricalciumphosphate bone substitute granules in caprine muscle tissue does not induce new bone formation

    PubMed Central

    2013-01-01

    Background Osteoinductive bone substitutes are defined by their ability to induce new bone formation even at heterotopic implantation sites. The present study was designed to analyze the potential osteoinductivity of two different bone substitute materials in caprine muscle tissue. Materials and methods One gram each of either a porous beta-tricalcium phosphate (β-TCP) or an hydroxyapatite/silicon dioxide (HA/SiO2)-based nanocrystalline bone substitute material was implanted in several muscle pouches of goats. The biomaterials were explanted at 29, 91 and 181 days after implantation. Conventional histology and special histochemical stains were performed to detect osteoblast precursor cells as well as mineralized and unmineralized bone matrix. Results Both materials underwent cellular degradation in which tartrate-resistant acid phosphatase (TRAP)-positive osteoclast-like cells and TRAP-negative multinucleated giant cells were involved. The ß-TCP was completely resorbed within the observation period, whereas some granules of the HA-groups were still detectable after 180 days. Neither osteoblasts, osteoblast precursor cells nor extracellular bone matrix were found within the implantation bed of any of the analyzed biomaterials at any of the observed time points. Conclusions This study showed that ß-TCP underwent a faster degradation than the HA-based material. The lack of osteoinductivity for both materials might be due to their granular shape, as osteoinductivity in goat muscle has been mainly attributed to cylindrical or disc-shaped bone substitute materials. This hypothesis however requires further investigation to systematically analyze various materials with comparable characteristics in the same experimental setting. PMID:23286366

  3. Implantation of silicon dioxide-based nanocrystalline hydroxyapatite and pure phase beta-tricalciumphosphate bone substitute granules in caprine muscle tissue does not induce new bone formation.

    PubMed

    Ghanaati, Shahram; Udeabor, Samuel E; Barbeck, Mike; Willershausen, Ines; Kuenzel, Oliver; Sader, Robert A; Kirkpatrick, C James

    2013-01-04

    Osteoinductive bone substitutes are defined by their ability to induce new bone formation even at heterotopic implantation sites. The present study was designed to analyze the potential osteoinductivity of two different bone substitute materials in caprine muscle tissue. One gram each of either a porous beta-tricalcium phosphate (β-TCP) or an hydroxyapatite/silicon dioxide (HA/SiO2)-based nanocrystalline bone substitute material was implanted in several muscle pouches of goats. The biomaterials were explanted at 29, 91 and 181 days after implantation. Conventional histology and special histochemical stains were performed to detect osteoblast precursor cells as well as mineralized and unmineralized bone matrix. Both materials underwent cellular degradation in which tartrate-resistant acid phosphatase (TRAP)-positive osteoclast-like cells and TRAP-negative multinucleated giant cells were involved. The ß-TCP was completely resorbed within the observation period, whereas some granules of the HA-groups were still detectable after 180 days. Neither osteoblasts, osteoblast precursor cells nor extracellular bone matrix were found within the implantation bed of any of the analyzed biomaterials at any of the observed time points. This study showed that ß-TCP underwent a faster degradation than the HA-based material. The lack of osteoinductivity for both materials might be due to their granular shape, as osteoinductivity in goat muscle has been mainly attributed to cylindrical or disc-shaped bone substitute materials. This hypothesis however requires further investigation to systematically analyze various materials with comparable characteristics in the same experimental setting.

  4. A biomechanical study on fixation stability with twin hook or lag screw in artificial cancellous bone.

    PubMed

    Olsson, O; Tanner, K E; Ceder, L; Ryd, L

    2002-01-01

    The twin hook has been developed as an alternative to the conventional lag screw to be combined with a barrelled side-plate in the treatment of trochanteric hip fractures. With two oppositely directed apical hooks introduced into the subchondral bone of the femoral head, the twin hook provides different stabilising properties to the lag screw. The femoral head purchase of the twin hook and the lag screw were compared in a biomechanical study using artificial cancellous bone, and responses to axial and torsional loading was determined. A distinct yield point in load and torque was noted for the lag screw, representing failure of the laminas supporting the threads. For the twin hook, gradual increase of load and torque occurred during impaction of the bone supporting the hooks. The peak loads and torques were higher for the lag screw, but were similar for both devices after 8 mm deformation. The stiffness was higher for the lag screw, but in counter-clockwise rotation the stiffness for the lag screw was negligible. The twin hook appeared to provide fixation stability comparable to that offered by the lag screw, but with conceivable advantages in terms of a deformation response involving bone impaction and gradually increasing stability.

  5. Synthesis and characterization of strontium-substituted hydroxyapatite nanoparticles for bone regeneration.

    PubMed

    Frasnelli, Matteo; Cristofaro, Francesco; Sglavo, Vincenzo M; Dirè, Sandra; Callone, Emanuela; Ceccato, Riccardo; Bruni, Giovanna; Cornaglia, Antonia Icaro; Visai, Livia

    2017-02-01

    The production of stable suspensions of strontium-substituted hydroxyapatite (Sr-HA) nanopowders, as Sr ions vector for bone tissue regeneration, was carried out in the present work. Sr-HA nanopowders were synthesized via aqueous precipitation methods using Sr(2+) amount from 0 to 100mol% and were characterized by several complementary techniques such as solid-state Nuclear Magnetic Resonance spectroscopy, X-ray diffraction, Infrared spectroscopy, N2 physisorption and Transmission Electron Microscopy. The substitution of Ca(2+) with Sr(2+) in HA is always isomorphic with gradual evolution between the two limit compositions (containing 100% Ca and 100% Sr), this pointing out the homogeneity of the synthesized nanopowders and the complete solubility of strontium in HA lattice. Strontium addition is responsible for an increasing c/a ratio in the triclinic unit cell. A significant variation of the nanopowders shape and dimension is also observed, a preferential growth along the c-axis direction being evident at higher strontium loads. Modifications in the local chemical environment of phosphate and hydroxyl groups in the apatite lattice are also observed. Stable suspensions were produced by dispersing the synthesized nanopowders in bovine serum albumin. Characterization by Dynamic Light Scattering and ζ-potential determination allowed to show that Ca(2+)→Sr(2+) substitution influences the hydrodynamic diameter, which is always twice the particles size determined by TEM, the nanoparticles being always negatively charged as a result from the albumin rearrangement upon the interaction with nanoparticles surface. The biocompatibility of the suspensions was studied in terms of cell viability, apoptosis, proliferation and morphology, using osteosarcoma cell line SAOS-2. The data pointed out an increased cell proliferation for HA nanoparticles containing larger Sr(2+) load, the cells morphology remaining essentially unaffected. Copyright © 2016 Elsevier B.V. All rights

  6. The effect of a biphasic injectable bone substitute on the interface strength in a rabbit knee prosthesis model

    PubMed Central

    2013-01-01

    Background In joint prosthetic surgery, various methods are used to provide implant stability. We used an injectable bone substitute, composed of calcium sulfate/hydroxyapatite, as bone defect filler to stabilize a tibia prosthesis in an experimental rabbit model. The aim of the study was to investigate and compare the stability of prosthetic fixation with and without the use of an injectable bone substitute. Methods Sixteen rabbits were used and the tibia prostheses were implanted bilaterally, one side with the prosthesis alone and the other side with the prosthesis and calcium sulfate/hydroxyapatite (Cerament™). The rabbits were randomly divided into two groups and euthanized after 6 and 12 weeks, respectively. The prosthesis was extracted measuring the pull-out force in an Instron tester, and the bone surrounding the former prosthesis site was analyzed by histology, histomorphometry, and micro-computed tomography. Results At 6 weeks no difference in maximum pull-out force was found between the prostheses fixed with or without Cerament™. At 12 weeks the maximum pull-out force for the prostheses with Cerament™ was significantly higher than that for the prostheses without Cerament™ (p = 0.04). The maximum pull-out force at 12 weeks was significantly higher than that at 6 weeks for the prostheses fixed with Cerament™ (p = 0.03) but not for the prostheses without. Conclusion We conclude that early prosthesis-bone interface strength is not influenced by a bone substitute. However, during remodeling, the bone substitute might provide improved mechanical support for the prosthesis. The results support further studies of the use of injectable calcium sulfate/hydroxyapatite in fixation of prosthetic joint implants. PMID:23899023

  7. Histological Study on a Novel Bone Graft Substitute: Human Derived Tooth-Hydroxyapatite Compared With Coralline Hydroxyapatite

    DTIC Science & Technology

    2007-11-02

    HISTOLOGICAL STUDY ON A NOVEL BONE GRAFT SUBSTITUTE: HUMAN DERIVED TOOTH -HYDROXYAPATITE COMPARED WITH CORALLINE HYDROXYAPATITE F. N. Oktar1, H...3] (second site morbidity), limited availability, anatomical and structural problems and tendency towards resorption [4]. Allogeneic tissue bears...METHODOLOGY In this study, HA prepared from human tooth (THA) and coralline HA (Pro Osteon 200, Interpore Cross, USA) (CHA) was used. THA

  8. Biomimetic chitosan-calcium phosphate composites with potential applications as bone substitutes: preparation and characterization.

    PubMed

    Tanase, Constantin E; Popa, Marcel I; Verestiuc, Liliana

    2012-04-01

    A novel biomimetic technique for obtaining chitosan-calcium phosphates (Cs-CP) scaffolds are presented: calcium phosphates are precipitated from its precursors, CaCl(2) and NaH(2) PO(4) on the Cs matrix, under physiological conditions (human body temperature and body fluid pH; 37°C and pH = 7.2, respectively). Materials composition and structure have been confirmed by various techniques: elemental analysis, Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), energy dispersive X-ray spectroscopy (EDX), and scanning electron microscopy (SEM). FTIR and SEM data have shown the arrangement of the calcium phosphates-hydroxyapatite (CP-Hap) onto Cs matrix. In this case the polymer is acting as glue, bonding the calcium phosphates crystals. Behavior in biological simulated fluids (phosphate buffer solution-PBS and PBS-albumin) revealed an important contribution of the chelation between -NH3(+) and Ca(2+) on the scaffold interaction with aqueous mediums; increased quantities of chitosan in composites permit the interaction with human albumin and improve the retention of fluid. The composites are slightly degraded by the lysozyme which facilitates an in vivo degradation control of bone substitutes. Modulus of elasticity is strongly dependent of the ratio chitosan/calcium phosphates and recommends the obtained biomimetic composites as promising materials for a prospective bone application. Copyright © 2011 Wiley Periodicals, Inc.

  9. Preparation and characterization of calcium phosphate ceramics and composites as bone substitutes

    NASA Astrophysics Data System (ADS)

    Zhang, Xing

    Marine CaCO3 skeletons have tailored architectures created by nature, which give them structural support and other functions. For example, seashells have dense lamellar structures, while coral, cuttlebone and sea urchin spines have interconnected porous structures. In our experiments, seashells, coral and cuttlebone were hydrothermally converted to hydroxyapatite (HAP), and sea urchin spines were converted to Mg-substituted tricalcium phosphate (beta-TCMP), while maintaining their original structures. Partially converted shell samples have mechanical strength, which is close to that of compact human bone. After implantation of converted shell and spine samples in rat femoral defects for 6 weeks, there was newly formed bone growth up to and around the implants. Some new bone was found to migrate through the pores of converted spine samples and grow inward. These results show good bioactivity and osteoconductivity of the implants, indicating the converted shell and spine samples can be used as bone defect fillers. Calcium phosphate powders were prepared through different synthesis methods. Micro-size HAP rods were synthesized by hydrothermal method through a nucleation-growth mechanism. On the other hand, HAP particles, which have good crystallinity, were prepared by wet precipitation with further hydrothermal treatment. beta-TCP or beta-TCMP powders were prepared by a two-step process: wet precipitation of apatitic tricalcium phosphate ('precursor') and calcination of the precursor at 800°C for 3 hours. beta-TCMP or beta-TCP powders were also prepared by solid-state reactions from CaHPO4 and CaCO 3 with/without MgO. Biphasic calcium phosphate, which is mixture of HAP and beta-TCP, can be prepared though mechanical mixing of HAP and beta-TCP powders synthesized as above. Dense beta-TCP and beta-TCMP ceramics can be produced by pressing green bodies at 100MPa and further sintering above 1100°C for 2 hours. beta-TCMP ceramics ˜99.4% relative dense were prepared by

  10. Partial physeal growth arrest treated by bridge resection and artificial dura substitute interposition.

    PubMed

    Inoue, Toshio; Naito, Masatoshi; Fujii, Toshio; Akiyoshi, Yuichiro; Yoshimura, Ichiro; Takamura, Kazuyuki

    2006-01-01

    We treated four cases of partial physeal growth arrest by resecting the bone bridge and interposing an expanded polytetrafluoroethylene membrane, which has minimal tissue response. We evaluated three cases with sufficiently long follow-up. No apparent recurrence of the bone bridge and no limb length discrepancy occurred in any of the cases. No remodeling after the operation occurred. In one case, which underwent this operation and corrective osteotomy of the proximal tibia, slight recurrence of the varus deformity occurred which was detected only by radiographs, and did not compromise the alignment of the leg. There were no complications.

  11. Statistical analysis of the behavior of fracture toughness of compound bioceramic artificial bone.

    PubMed

    Xu, Shilian; Xu, Renping; Li, Ruoqi

    2011-12-01

    We show the manufacturing procedure of the test specimen of the compound bioceramic artificial bone, conduct experiments to measure its fracture toughness, and conclude that the experiment data conform to the two-parameter Weibull distribution with scale parameter β = 0.527369 and form parameter α = 5.24317. Furthermore, compound bioceramic artificial bone is of a high level of crack sensitivity and its data for the fracture toughness is has a high dispersion. We also analyze the evolution of the confidence level of the reliability of its fracture toughness. With the increase of the confidence level γ, the crack sensitivity increases, but the median, the discreteness, and the confidence intervals decrease. The size of the test specimen influences the experiment for the fracture toughness, the measured values and their dispersion, and there exists the conversion between size of the test specimen and that of the real device. We extend the results to introduce the statistic model of the size effect of the fracture toughness.

  12. Hydroxyapatite reinforced with multi-walled carbon nanotubes and bovine serum albumin for bone substitute applications

    NASA Astrophysics Data System (ADS)

    Gholami, Fatemeh; Noor, Ahmad-Fauzi Mohd

    2016-12-01

    The similarity of the chemical composition of HA to the mineral phase of bone and its excellent biocompatibility meets the requirement of materials designed for bone substitute purpose. The application of HA in load bearing devices is limited by its poor mechanical properties. CNTs with outstanding stiffness, strength, combined with their small size and large interfacial area, suggest that they may have great potential as a reinforcing agent for HA. This work aims to develop the Hydroxyapatite/Multi-walled Carbon Nanotubes/Bovine Serum Albumin (HA/MWCNTs/BSA) composites with different types of MWCNTs including hydroxylated and carboxylated MWCNTs (MWCNTs-OH, MWCNTs-COOH), and evaluation of mechanical strength and in vitro cellular response of developed composites. HA powder was mixed with de-ionized water, 15 wt.% BSA, and 0.5 wt.% of different MWCNTs* (> 95%), MWCNTs (> 99.9%), MWCNTs-OH (> 99.9%), MWCNTs-COOH (> 99.9%) to produce composites. Among all developed composites, the HA/MWCNTs-COOH/BSA shows the highest compressive strength (29.57 MPa). The cytotoxic effect of HA/MWCNTs-COOH/BSA with different concentrations (6.25 to 200 µg/ml) was evaluated by MTT assay against normal human colon fibroblast (CCD-18Co cell line). At low concentration, all developed composites were found to be non-cytotoxic when treated to the human fibroblast cells and did not elicit cytotoxic effects on cell proliferation and the highest values of cell viability (283%) for the HA/MWCNTs-COOH/BSA composites obtained; whereas when the concentration was increased, the reduction in cell viability was observed. The novel composites showed favorable cytocompatibility with improved compressive strength which make it applicable to use in range of trabecular bone.

  13. Bone substitute material composition and morphology differentially modulate calcium and phosphate release through osteoclast-like cells.

    PubMed

    Konermann, A; Staubwasser, M; Dirk, C; Keilig, L; Bourauel, C; Götz, W; Jäger, A; Reichert, C

    2014-04-01

    The aim of this study was to determine the material composition and cell-mediated remodelling of different calcium phosphate-based bone substitutes. Osteoclasts were cultivated on bone substitutes (Cerabone, Maxresorb, and NanoBone) for up to 5 days. Bafilomycin A1 addition served as the control. To determine cellular activity, the supernatant content of calcium and phosphate was measured by inductively coupled plasma optical emission spectrometry. Cells were visualized on the materials by scanning electron microscopy. Material composition and surface characteristics were assessed by energy-dispersive X-ray spectroscopy. Osteoclast-induced calcium and phosphate release was material-specific. Maxresorb exhibited the highest ion release to the medium (P = 0.034; calcium 40.25mg/l day 5, phosphate 102.08 mg/l day 5) and NanoBone the lowest (P = 0.021; calcium 8.43 mg/l day 5, phosphate 15.15 mg/l day 5); Cerabone was intermediate (P = 0.034; calcium 16.34 mg/l day 5, phosphate 30.6 mg/l day 5). All investigated materials showed unique resorption behaviours. The presented methodology provides a new perspective on the investigation of bone substitute biodegradation, maintaining the material-specific micro- and macrostructure. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Analysis of Impingement between Patella Bone and Bearing Post in Cruciate-Substituting High-Flexion Total Knee Arthroplasty.

    PubMed

    Chon, Jegyun; Lee, Bongju; Shin, Sangyeop; Jang, Gunil; Jeon, Taehyeon

    2016-06-01

    We investigated the causes of impingement between the patella bone and the bearing post during high flexion in cruciate-substituting total knee arthroplasty and proposed a treatment strategy. This prospective cohort study included 218 cases that had undergone cruciate-substituting total knee arthroplasty from February 2014 to January 2015; a single surgeon performed the operation using the same method without patellar resurfacing in all patients. In these patients, the occurrence of impingement was determined by performing more than 120° high knee flexion after inserting a bearing perioperatively. The incidence of impingement was significantly associated with bearing design, femoral implant size, patella bone length, and patella inferior pole angle (p < 0.05). The impingement was resolved by resection of the lower articular side of the patella bone. In the cruciate-substituting high-flexion total knee arthroplasty, impingement between the patella bone and bearing post was more common in patients with mobile bearing, small-size femoral component, and a long patella or a large inferior pole angle. In cases of intraoperative impingement between the patella bone and the bearing post, resection in the lower portion of the patella prevented impingement of the bearing with soft tissue or the patella by widening the space between the patella and the bearing post, which in turn prevented postoperative reduction in range of motion.

  15. Analysis of Impingement between Patella Bone and Bearing Post in Cruciate-Substituting High-Flexion Total Knee Arthroplasty

    PubMed Central

    Chon, Jegyun; Shin, Sangyeop; Jang, Gunil; Jeon, Taehyeon

    2016-01-01

    Background We investigated the causes of impingement between the patella bone and the bearing post during high flexion in cruciate-substituting total knee arthroplasty and proposed a treatment strategy. Methods This prospective cohort study included 218 cases that had undergone cruciate-substituting total knee arthroplasty from February 2014 to January 2015; a single surgeon performed the operation using the same method without patellar resurfacing in all patients. Results In these patients, the occurrence of impingement was determined by performing more than 120° high knee flexion after inserting a bearing perioperatively. The incidence of impingement was significantly associated with bearing design, femoral implant size, patella bone length, and patella inferior pole angle (p < 0.05). The impingement was resolved by resection of the lower articular side of the patella bone. Conclusions In the cruciate-substituting high-flexion total knee arthroplasty, impingement between the patella bone and bearing post was more common in patients with mobile bearing, small-size femoral component, and a long patella or a large inferior pole angle. In cases of intraoperative impingement between the patella bone and the bearing post, resection in the lower portion of the patella prevented impingement of the bearing with soft tissue or the patella by widening the space between the patella and the bearing post, which in turn prevented postoperative reduction in range of motion. PMID:27247740

  16. Synthesis and biological screening by novel hybrid fluorocarbon hydrocarbon compounds for use as artificial blood substitutes

    NASA Technical Reports Server (NTRS)

    Moacanin, J.; Scherer, K.; Toronto, A.; Lawson, D.; Terranova, T.; Yavrouian, A.; Astle, L.; Harvey, S.; Kaaelble, D. H.

    1979-01-01

    A series of hybrid fluorochemicals of general structure R(1)R(2)R(3)CR(4) was prepared where the R(i)'s (i=1,2,3) is a saturated fluoroalkyl group of formula C sub N F sub 2n+1, and R(4) is an alkyl group C sub n H sub 2n+1 or a related moiety containing amino, ether, or ester functions but no CF bonds. Compounds of this class containing approximately eight to twenty carbons total have physical properties suitable for use as the oxygen carrying phase of fluorochemical emulsion artificial blood. The chemical synthesis, and physical and biological testing of pure single isomers of the proposed artificial blood candidate compounds are included. Significant results are given.

  17. Augmentation of tibial plateau fractures with an injectable bone substitute: CERAMENT™. Three year follow-up from a prospective study.

    PubMed

    Iundusi, Riccardo; Gasbarra, Elena; D'Arienzo, Michele; Piccioli, Andrea; Tarantino, Umberto

    2015-05-13

    Reduction of tibial plateau fractures and maintain a level of well aligned congruent joint is key to a satisfactory clinical outcome and is important for the return to pre-trauma level of activity. Stable internal fixation support early mobility and weight bearing. The augmentation with bone graft substitute is often required to support the fixation to mantain reduction. For these reasons there has been development of novel bone graft substitutes for trauma applications and in particular synthetic materials based on calcium phosphates and/or apatite combined with calcium sulfates. Injectable bone substitutes can optimize the filling of irregular bone defects. The purpose of this study was to assess the potential of a novel injectable bone substitute CERAMENT™|BONE VOID FILLER in supporting the initial reduction and preserving alignment of the joint surface until fracture healing. From June 2010 through May 2011 adult patients presenting with acute, closed and unstable tibial plateau fractures which required both grafting and internal fixation, were included in a prospective study with percutaneous or open reduction and internal fixation (ORIF) augmented with an injectable ceramic biphasic bone substitute CERAMENT™|BONE VOID FILLER (BONESUPPORT™, Lund, Sweden) to fill residual voids. Clinical follow up was performed at 1, 3, 9 and 12 months and any subsequent year; including radiographic analysis and Rasmussen system for knee functional grading. Twenty four patients, balanced male-to-female, with a mean age of 47 years, were included and followed with an average of 44 months (range 41-52 months). Both Schatzker and Müller classifications were used and was type II or 41-B3 in 7 patients, type III or 41-B2 in 12 patients, type IV or 41-C1 in 2 patients and type VI or 41-C3 in 3 patients, respectively. The joint alignement was satisfactory and manteined within a range of 2 mm, with an average of 1.18 mm. The mean Rasmussen knee function score was 26.5, with 14

  18. Two types of totally artificial red blood cell substitutes liposome embedded heme(L/H) and lipidheme/microsphere(LHM).

    PubMed

    Kobayashi, K; Kakizaki, T; Komatsu, T; Nishide, H; Tsuchida, E

    1994-01-01

    Two types of totally artificial oxygen carriers were produced (1)by embedding synthetic lipidhemes (as oxygen carriers) in bilayers of liposomes as vehicles of lipidhemes (L/H) and (2)by covering clinically available fat droplets (triglyceride microspheres) with synthetic lipidhemes (LHM). Fat droplets were used as vehicles of lipidhemes. Their oxygen carrying ability in vivo was examined in beagles undergoing hemorrhagic shock. L/H delivered 15.7 to 19.2% of total oxygen delivery. From 12.7 to 24.4% of total oxygen consumption was from L/H. LHM delivered 11.6 to 7.3% of total oxygen delivery. From 13.1 to 16.4% of total oxygen consumption was from LHM. These totally synthetic red blood cell substitutes can be candidates for future clinical testing.

  19. Fibrin gel-immobilized primary osteoblasts in calcium phosphate bone cement: in vivo evaluation with regard to application as injectable biological bone substitute.

    PubMed

    Kneser, U; Voogd, A; Ohnolz, J; Buettner, O; Stangenberg, L; Zhang, Y H; Stark, G B; Schaefer, D J

    2005-01-01

    Osteogenic injectable bone substitutes may be useful for many applications. We developed a novel injectable bone substitute based on osteoblast-fibrin glue suspension and calcium phosphate bone cement (BC). Human osteoblasts were isolated from trabecular bone samples and cultured under standard conditions. Osteoblasts were suspended in fibrinogen solution (FS). BC was cured with thrombin solution. 8 x 4 mm injectable bone discs were prepared using silicon molds and a custom-made applicator device. Discs containing BC, BC/FS, or BC/FS/osteoblasts were implanted subcutaneously into athymic nude mice. After 3, 9 and 24 weeks, specimens were explanted and subjected to morphologic and biomechanical evaluation. In vitro fibrin gel-embedded osteoblasts displayed a differentiated phenotype as evidenced by alkaline phosphatase, collagen type 1 and von Kossa stains. A proportion of osteoblasts appeared morphologically intact over a 3-day in vitro period following application into the BC. BC/FS and BC/FS/osteoblast discs were sparsely infiltrated with vascularized connective tissue. There was no bone formation in implants from all groups. However, positive von Kossa staining only in BC/FS/osteoblast groups suggests engraftment of at least some of the transplanted cells. Biomechanical evaluation demonstrated initial stability of the composites. Young's modulus and maximal load did not differ significantly in the BC/FS and BC/FS/osteoblast groups. The practicability of osteoblast-containing injectable bone could be demonstrated. The dense microstructure and the suboptimal initial vascularization of the composites may explain the lack of bone formation. Modifications with regard to enhanced osteoblast survival are mandatory for a possible application as injectable osteogenic bone replacement system.

  20. Evaluation of bovine-derived bone protein with a natural coral carrier as a bone-graft substitute in a canine segmental defect model.

    PubMed

    Sciadini, M F; Dawson, J M; Johnson, K D

    1997-11-01

    The efficacy of a bone-graft substitute (bovine-derived bone protein in a carrier of natural coral) in the healing of a segmental defect of a weight-bearing long bone was evaluated. Twenty dogs, divided into two groups, underwent bilateral radial osteotomies with creation of a 2.5 cm defect. On one side of each dog, the defect was filled with autogenous cancellous bone graft. Contralateral defects received, in a blinded randomized fashion, cylindrical implants consisting of natural coral (calcium carbonate) or calcium carbonate enhanced with a standard dose of bovine-derived bone protein (3.0 mg/implant; 0.68 mg bone protein/cm3). The limbs were stabilized with external fixators, and all animals underwent monthly radiographs. They were killed at 12 (group 1) or 24 (group 2) weeks, and regenerated bone was studied by biomechanical testing and histology. Radiographic union developed in all 20 radii with autogenous cancellous bone grafts and in all 10 of the radii with the composite implants. None of the radii with implants of calcium carbonate alone showed radiographic evidence of union. This represented a statistically significant difference between implant types. In addition, calcium carbonate implants both with and without bone protein demonstrated radiographic evidence of near total resorption of the radiodense carrier by 12 weeks. This resorption facilitated radiographic evaluation of healing. Mean values for biomechanical parameters of radii with the composite implants exceeded those for the contralateral controls at 12 and 24 weeks; the difference was statistically significant at 12 weeks. Histology revealed scant residual calcium carbonate carrier at either time in the defects with calcium carbonate implants; however, a moderate amount was present in defects with the composite implants. In these specimens, the residual carrier was completely surrounded by newly formed bone that may have insulated the calcium carbonate from further degradation. The present

  1. Evaluation of hydroxyapatite and beta-tricalcium phosphate mixed with bone marrow aspirate as a bone graft substitute for posterolateral spinal fusion.

    PubMed

    Bansal, Sanjay; Chauhan, Vijendra; Sharma, Sansar; Maheshwari, Rajesh; Juyal, Anil; Raghuvanshi, Shailendra

    2009-07-01

    Autologous cancellous bone is the most effective biological graft material. However, harvest of autologous bone is associated with significant morbidity. Since porous hydroxyapatite and beta-tricalcium phosphate are biodegradable materials and can be replaced by bone tissue, but it lacks osteogenic property. We conducted a study to assess their use as a scaffold and combine them with bone marrow aspirate for bone regeneration using its osteogenic property for posterolateral spinal fusion on one side and autologous bone graft on the other side and compare them radiologically in terms of graft incorporation and fusion. Thirty patients with unstable dorsal and lumbar spinal injuries who needed posterior stabilization and fusion were evaluated in this prospective study from October 2005 to March 2008. The posterior stabilization was done using pedicle screw and rod assembly, and fusion was done using hydroxyapatite and beta-tricalcium phosphate mixed with bone marrow aspirate as a bone graft substitute over one side of spine and autologous bone graft obtained from iliac crest over other side of spine. The patients were followed up to a minimum of 12 months. Serial radiographs were done at an interval of 3, 6, and 12 months and CT scan was done at one year follow-up. Graft incorporation and fusion were assessed at each follow-up. The study was subjected to statistical analysis using chi-square and kappa test to assess graft incorporation and fusion. At the end of the study, radiological graft incorporation and fusion was evident in all the patients on the bone graft substitute side and in 29 patients on the autologous bone graft side of the spine (P > 0.05). One patient showed lucency and breakage of distal pedicle screw in autologous bone graft side. The interobserver agreement (kappa) had an average of 0.72 for graft incorporation, 0.75 for fusion on radiographs, and 0.88 for the CT scan findings. Hydroxyapatite and beta-tricalcium phosphate mixed with bone marrow

  2. Evaluation of hydroxyapatite and beta-tricalcium phosphate mixed with bone marrow aspirate as a bone graft substitute for posterolateral spinal fusion

    PubMed Central

    Bansal, Sanjay; Chauhan, Vijendra; Sharma, Sansar; Maheshwari, Rajesh; Juyal, Anil; Raghuvanshi, Shailendra

    2009-01-01

    Background: Autologous cancellous bone is the most effective biological graft material. However, harvest of autologous bone is associated with significant morbidity. Since porous hydroxyapatite and beta-tricalcium phosphate are biodegradable materials and can be replaced by bone tissue, but it lacks osteogenic property. We conducted a study to assess their use as a scaffold and combine them with bone marrow aspirate for bone regeneration using its osteogenic property for posterolateral spinal fusion on one side and autologous bone graft on the other side and compare them radiologically in terms of graft incorporation and fusion. Materials and Methods: Thirty patients with unstable dorsal and lumbar spinal injuries who needed posterior stabilization and fusion were evaluated in this prospective study from October 2005 to March 2008. The posterior stabilization was done using pedicle screw and rod assembly, and fusion was done using hydroxyapatite and beta-tricalcium phosphate mixed with bone marrow aspirate as a bone graft substitute over one side of spine and autologous bone graft obtained from iliac crest over other side of spine. The patients were followed up to a minimum of 12 months. Serial radiographs were done at an interval of 3, 6, and 12 months and CT scan was done at one year follow-up. Graft incorporation and fusion were assessed at each follow-up. The study was subjected to statistical analysis using chi-square and kappa test to assess graft incorporation and fusion. Results: At the end of the study, radiological graft incorporation and fusion was evident in all the patients on the bone graft substitute side and in 29 patients on the autologous bone graft side of the spine (P > 0.05). One patient showed lucency and breakage of distal pedicle screw in autologous bone graft side. The interobserver agreement (kappa) had an average of 0.72 for graft incorporation, 0.75 for fusion on radiographs, and 0.88 for the CT scan findings. Conclusion: Hydroxyapatite

  3. Minimally Invasive Alveolar Ridge Preservation Utilizing an In Situ Hardening β-Tricalcium Phosphate Bone Substitute: A Multicenter Case Series

    PubMed Central

    Leventis, Minas D.; Fairbairn, Peter; Kakar, Ashish; Leventis, Angelos D.; Margaritis, Vasileios; Lückerath, Walter; Horowitz, Robert A.; Rao, Bappanadu H.; Lindner, Annette; Nagursky, Heiner

    2016-01-01

    Ridge preservation measures, which include the filling of extraction sockets with bone substitutes, have been shown to reduce ridge resorption, while methods that do not require primary soft tissue closure minimize patient morbidity and decrease surgical time and cost. In a case series of 10 patients requiring single extraction, in situ hardening beta-tricalcium phosphate (β-TCP) granules coated with poly(lactic-co-glycolic acid) (PLGA) were utilized as a grafting material that does not necessitate primary wound closure. After 4 months, clinical observations revealed excellent soft tissue healing without loss of attached gingiva in all cases. At reentry for implant placement, bone core biopsies were obtained and primary implant stability was measured by final seating torque and resonance frequency analysis. Histological and histomorphometrical analysis revealed pronounced bone regeneration (24.4 ± 7.9% new bone) in parallel to the resorption of the grafting material (12.9 ± 7.7% graft material) while high levels of primary implant stability were recorded. Within the limits of this case series, the results suggest that β-TCP coated with polylactide can support new bone formation at postextraction sockets, while the properties of the material improve the handling and produce a stable and porous bone substitute scaffold in situ, facilitating the application of noninvasive surgical techniques. PMID:27190516

  4. Electrospun Yarn Reinforced NanoHA Composite Matrix as a Potential Bone Substitute for Enhanced Regeneration of Segmental Defects.

    PubMed

    Anitha, A; Joseph, John; Menon, Deepthy; Nair, Shantikumar V; Nair, Manitha B

    2017-04-01

    Nanohydroxyapatite (nanoHA) is a well-established synthetic bone substitute with excellent osteoconduction and osteointegration. However, brittleness coupled with slow degradation curtails its load-bearing and bone regeneration potential, respectively. To address these limitations, nanoHA composite matrix reinforced with electrospun fibrous yarns was fabricated and tested in vitro and in vivo. Different weight percentages (5, 10, 15 wt%) and varying lengths (short and continuous) of poly(l-lactic acid) yarns were randomly dispersed in a gelatinous matrix containing nanoHA. This significantly improved the compressive strength as well as work of fracture, especially for continuous yarns at high weight percentages (10 and 15 wt%). Incorporation of yarns did not adversely affect the pore size (50-350 μm) or porosity of the scaffolds as well as the in vitro cellular response. Finally, when tested in a critical-sized femoral segmental defect in rat, the nanocomposite scaffolds induced osteoblast cell infiltration at 2 months that subsequently underwent increased mature lamellar bone formation at 4 months, in both the mid and peripheral defect regions. Histomorphometric analysis demonstrated that new bone formation and biomaterial degradation were significantly enhanced in the composite scaffold when compared to commercially available HA. Overall, the composite matrix reinforced with electrospun yarns proved to be a potential bone substitute having an appropriate balance between mechanical strength, porosity, biodegradation, and bone regeneration ability.

  5. Investigation on artificial blood or substitute blood replace the natural blood

    PubMed Central

    Keyhanian, Sh; Ebrahimifard, M; Zandi, M

    2014-01-01

    Blood is a liquid tissue in which dissolved with abundant chemical factors and millions of different cells The reduction of unwanted side effects, especially diseases that emerge through blood such as HIV and hepatitis, has a significant role for modern medicine of transfusion and transplantation. The issues and costs of human blood collection and storage, direct this procedure towards the use of alternatives blood. Two important research fields of this area were oxygen carriers based on hemoglobin and perfluoro chemicals. While they do not have the same quality as the blood cell products, the oxygen carrier solutions have potential clinical and non-clinical applications. The result showed that these products can reach to the body tissues easier than normal red blood cells, and can control the oxygen directly. The final aim of transfusion is to establish a transfusion system with no side effects, and the fact that oxygen carrier artificial blood has this property. The article attempts to step towards solving some problems of blood transfusion through describing the properties of artificial blood alternatives PMID:25002929

  6. Investigation on artificial blood or substitute blood replace the natural blood.

    PubMed

    Keyhanian, Sh; Ebrahimifard, M; Zandi, M

    2014-01-01

    Blood is a liquid tissue in which dissolved with abundant chemical factors and millions of different cells The reduction of unwanted side effects, especially diseases that emerge through blood such as HIV and hepatitis, has a significant role for modern medicine of transfusion and transplantation. The issues and costs of human blood collection and storage, direct this procedure towards the use of alternatives blood. Two important research fields of this area were oxygen carriers based on hemoglobin and perfluoro chemicals. While they do not have the same quality as the blood cell products, the oxygen carrier solutions have potential clinical and non-clinical applications. The result showed that these products can reach to the body tissues easier than normal red blood cells, and can control the oxygen directly. The final aim of transfusion is to establish a transfusion system with no side effects, and the fact that oxygen carrier artificial blood has this property. The article attempts to step towards solving some problems of blood transfusion through describing the properties of artificial blood alternatives.

  7. Bone regeneration in the presence of a synthetic hydroxyapatite/silica oxide-based and a xenogenic hydroxyapatite-based bone substitute material.

    PubMed

    Kruse, A; Jung, R E; Nicholls, F; Zwahlen, R A; Hämmerle, C H F; Weber, F E

    2011-05-01

    A comparison of synthetic hydroxyapatite/silica oxide, xenogenic hydroxyapatite-based bone substitute materials with empty control sites in terms of bone regeneration enhancement in a rabbit calvarial four non-critical-sized defect model. In each of six rabbits, four bicortical calvarial bone defects were generated. The following four treatment modalities were randomly allocated: (1) empty control site, (2) synthetic hydroxyapatite/silica oxide-based (HA/SiO) test granules, (3) xenogenic hydroxyapatite -based granules, (4) synthetic hydroxyapatite/silica oxide -based (HA/SiO) test two granules. The results of the latter granules have not been reported due to their size being three times bigger than the other two granule types. After 4 weeks, the animals were sacrificed and un-decalcified sections were obtained for histological analyses. For statistical analysis, the Kruskal-Wallis test was applied (P<0.05). Histomorphometric analysis showed an average area fraction of newly formed bone of 12.32±10.36% for the empty control, 17.47±6.42% for the xenogenic hydroxyapatite -based granules group, and 21.2±5.32% for the group treated with synthetic hydroxyapatite/silica oxide -based granules. Based on the middle section, newly formed bone bridged the defect to 38.33±37.55% in the empty control group, 54.33±22.12% in the xenogenic hydroxyapatite -based granules group, and to 79±13.31% in the synthetic hydroxyapatite/silica oxide -based granules group. The bone-to-bone substitute contact was 46.38±18.98% for the xenogenic and 59.86±14.92% for the synthetic hydroxyapatite/silica oxide-based granules group. No significant difference in terms of bone formation and defect bridging could be detected between the two bone substitute materials or the empty defect. There is evidence that the synthetic hydroxyapatite/silica oxide granules provide comparable results with a standard xenogenic bovine mineral in terms of bone formation and defect bridging in non-critical size

  8. A Bone Sample Containing a Bone Graft Substitute Analyzed by Correlating Density Information Obtained by X-ray Micro Tomography with Compositional Information Obtained by Raman Microscopy

    PubMed Central

    Charwat-Pessler, Johann; Musso, Maurizio; Petutschnigg, Alexander; Entacher, Karl; Plank, Bernhard; Wernersson, Erik; Tangl, Stefan; Schuller-Götzburg, Peter

    2015-01-01

    The ability of bone graft substitutes to promote new bone formation has been increasingly used in the medical field to repair skeletal defects or to replace missing bone in a broad range of applications in dentistry and orthopedics. A common way to assess such materials is via micro computed tomography (µ-CT), through the density information content provided by the absorption of X-rays. Information on the chemical composition of a material can be obtained via Raman spectroscopy. By investigating a bone sample from miniature pigs containing the bone graft substitute Bio Oss®, we pursued the target of assessing to what extent the density information gained by µ-CT imaging matches the chemical information content provided by Raman spectroscopic imaging. Raman images and Raman correlation maps of the investigated sample were used in order to generate a Raman based segmented image by means of an agglomerative, hierarchical cluster analysis. The resulting segments, showing chemically related areas, were subsequently compared with the µ-CT image by means of a one-way ANOVA. We found out that to a certain extent typical gray-level values (and the related histograms) in the µ-CT image can be reliably related to specific segments within the image resulting from the cluster analysis. PMID:28793410

  9. A Bone Sample Containing a Bone Graft Substitute Analyzed by Correlating Density Information Obtained by X-ray Micro Tomography with Compositional Information Obtained by Raman Microscopy.

    PubMed

    Charwat-Pessler, Johann; Musso, Maurizio; Petutschnigg, Alexander; Entacher, Karl; Plank, Bernhard; Wernersson, Erik; Tangl, Stefan; Schuller-Götzburg, Peter

    2015-06-25

    The ability of bone graft substitutes to promote new bone formation has been increasingly used in the medical field to repair skeletal defects or to replace missing bone in a broad range of applications in dentistry and orthopedics. A common way to assess such materials is via micro computed tomography (µ-CT), through the density information content provided by the absorption of X-rays. Information on the chemical composition of a material can be obtained via Raman spectroscopy. By investigating a bone sample from miniature pigs containing the bone graft substitute Bio Oss(®), we pursued the target of assessing to what extent the density information gained by µ-CT imaging matches the chemical information content provided by Raman spectroscopic imaging. Raman images and Raman correlation maps of the investigated sample were used in order to generate a Raman based segmented image by means of an agglomerative, hierarchical cluster analysis. The resulting segments, showing chemically related areas, were subsequently compared with the µ-CT image by means of a one-way ANOVA. We found out that to a certain extent typical gray-level values (and the related histograms) in the µ-CT image can be reliably related to specific segments within the image resulting from the cluster analysis.

  10. PET fiber fabrics modified with bioactive titanium oxide for bone substitutes.

    PubMed

    Kokubo, Tadashi; Ueda, Takahiro; Kawashita, Masakazu; Ikuhara, Yuichi; Takaoka, Gikan H; Nakamura, Takashi

    2008-02-01

    A rectangular specimen of polyethylene terephthalate (PET) was soaked in a titania solution composed of titanium isopropoxide, water, ethanol and nitric acid at 25 degrees C for 1 h. An amorphous titanium oxide was formed uniformly on the surface of PET specimen, but did not form an apatite on its surface in a simulated body fluid (SBF) within 3 d. The PET plate formed with the amorphous titanium oxide was subsequently soaked in water or HCl solutions with different concentrations at 80 degrees C for different periods of time. The titanium oxide on PET was transformed into nano-sized anatase by the water treatment and into nano-sized brookite by 0.10 M HCl treatment at 80 degrees C for 8 d. The former did not form the apatite on its surface in SBF within 3 d, whereas the latter formed the apatite uniformly on its surface. Adhesive strength of the titanium oxide and apatite layers to PET plate was increased by pre-treatment of PET with 2 wt% NaOH solution at 40 degrees C for 2 h. A two-dimensional fabric of PET fibers 24 microm in diameter was subjected to the NaOH pre-treatment at 40 degrees C, titania solution treatment at 25 degrees C and subsequent 0.10 M HCl treatment at 80 degrees C. Thus treated PET fabric formed the apatite uniformly on surfaces of individual fibers constituting the fabric in SBF within 3 d. Two or three dimensional PET fabrics modified with the nano-sized brookite on surfaces of the individual fibers constituting the fabric by the present method are believed to be useful as flexible bone substitutes, since they could be integrated with living bone through the apatite formed on their constituent fibers.

  11. Fiber reinforced calcium phosphate cements -- on the way to degradable load bearing bone substitutes?

    PubMed

    Krüger, Reinhard; Groll, Jürgen

    2012-09-01

    Calcium phosphate cements (CPC) are well-established materials for the repair of bone defects with excellent biocompatibility and bioactivity. However, brittleness and low flexural/tensile strength so far restrict their application to non-load bearing areas. Reinforcement of CPC with fibers can substantially improve its strength and toughness and has been one major strategy to overcome the present mechanical limitations of CPC. Fiber reinforced calcium phosphate cements (FRCPC) thus bear the potential to facilitate the use of degradable bone substitutes in load bearing applications. This review recapitulates the state of the art of FRCPC research with focus on their mechanical properties and their biological evaluation in vitro and in vivo, including the clinical data that has been generated so far. After an overview on FRCPC constitutes and processing, some general aspects of fracture mechanics of reinforced cementitious composites are introduced, and their importance for the mechanical properties of FRCPC are highlighted. So far, fiber reinforcement leads to a toughness increase of up to two orders of magnitude. FRCPC have extensively been examined in vitro and in vivo with generally good results. While first clinical products focus on the improved performance of FRCPC with regard to secondary processing after injection such as fixation of screws and plates, first animal studies in load bearing applications show improved performance as compared to pure CPCs. Aside of the accomplished results, FRCPC bear a great potential for future development and optimization. Future research will have to focus on the selection and tailoring of FRCPC components, fiber-matrix compatibilization, integral composite design and the adjusted degradation behavior of the composite components to ensure successful long term behavior and make the composites strong enough for application in load bearing defects. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Direct 3D powder printing of biphasic calcium phosphate scaffolds for substitution of complex bone defects.

    PubMed

    Castilho, Miguel; Moseke, Claus; Ewald, Andrea; Gbureck, Uwe; Groll, Jürgen; Pires, Inês; Teßmar, Jörg; Vorndran, Elke

    2014-03-01

    The 3D printing technique based on cement powders is an excellent method for the fabrication of individual and complex bone substitutes even in the case of large defects. The outstanding bone remodeling capacity of biphasic calcium phosphates (BCPs) containing hydroxyapatite (HA) as well as tricalcium phosphate (TCP) in varying ratios makes the adaption of powder systems resulting in BCP materials to this fabrication technique a desirable aim. This study presents the synthesis and characterization of a novel powder system for the 3D printing process, intended for the production of complexly shaped BCP scaffolds by a hydraulic setting reaction of calcium carbonate and TCP with phosphoric acid. The HA/TCP ratio in the specimens could be tailored by the calcium/phosphate ratio of the starting powder. The scaffolds could be fabricated with a dimensional accuracy of >96.5% and a minimal macro pore size of 300 µm. Independent of the phase composition the printed specimens showed a microporosity of approximately 68%, while the compressive strength strongly depended on the chemical composition and increased with rising TCP content in the scaffolds to a maximum of 1.81 MPa. Post-treatment of the scaffolds with a polylactic-co-glycolic acid-solution enhanced the mechanical properties by a factor of 8. In vitro studies showed that all BCP scaffolds were cytocompatible and enhanced the cell viability as well as the cell proliferation, as compared with pure TCP. Cell proliferation is even better on BCP when compared to HA and cell viability is in a similar range on these materials.

  13. Artificial Bone and Teeth through Controlled Ice Growth in Colloidal Suspensions

    SciTech Connect

    Tomsia, Antoni P.; Saiz, Eduardo; Deville, Sylvain

    2007-06-14

    The formation of regular patterns is a common feature of many solidification processes involving cast materials. We describe here how regular patterns can be obtained in porous alumina and hydroxyapatite (HAP) by controlling the freezing of ceramic slurries followed by subsequent ice sublimation and sintering, leading to multilayered porous ceramic structures with homogeneous and well-defined architecture. These porous materials can be infiltrated with a second phase of choice to yield biomimetic nacre-like composites with improved mechanical properties, which could be used for artificial bone and teeth applications. Proper control of the solidification patterns provides powerful means of control over the final functional properties. We discuss the relationships between the experimental results, ice growth fundamentals, the physics of ice and the interaction between inert particles and the solidification front during directional freezing.

  14. The cross-linked biopolymer hyaluronic acid as an artificial vitreous substitute.

    PubMed

    Schramm, Charlotte; Spitzer, Martin S; Henke-Fahle, Sigrid; Steinmetz, Gabriele; Januschowski, Kai; Heiduschka, Peter; Geis-Gerstorfer, Jürgen; Biedermann, Tilo; Bartz-Schmidt, Karl U; Szurman, Peter

    2012-02-02

    Biopolymers are promising substances in the development of a new vitreous substitute to overcome the drawbacks associated with current hydrophobic tamponade materials. Different hydrogels were assembled by cross-linking hyaluronic acid either with adipic dihydrazide (ADH) by carboxylation with N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide hydrochloride (EDCI) after hydrazation or by photocrosslinking with UV-light and N-vinyl-pyrrolidinone. The refractive index and rheologic properties of the obtained gels were investigated. To quantify the degradation of the hydrogels over time, free hyaluronic acid was measured photometrically by means of the degradation product uronic acid. For biocompatibility testing, the hydrogels were applied on top of cultured retinal pigment epithelial (RPE) cells and analyzed by the cell viability, MTT, and alamar blue viability cytotoxicity assays and flow cytometry, with Annexin V-FITC and propidium iodide co-staining. The in vivo biocompatibility of the hydrogels was tested in vitrectomized rabbit eyes for up to 6 weeks. The synthesized hydrogels were all clear and transparent and had a refractive index similar to human vitreous. The rheologic measurements suggested sufficient viscosity and elasticity for intraocular use. Quantification of the degradation products revealed only a small decay of the gels over 1 month. However, the ADH cross-linked hydrogels induced mild cytotoxicity in the RPE cells. The UV cross-linked hydrogels showed no toxicity or induction of apoptosis. In vivo the UV cross-linked biogels remained in place for 6 weeks, and electrophysiology and histology showed excellent tissue biocompatibility. Biopolymers based on UV cross-linked hyaluronic acid may be promising vitreous substitutes.

  15. Composite coating of 58S bioglass and hydroxyapatite on a poly (ethylene terepthalate) artificial ligament graft for the graft osseointegration in a bone tunnel

    NASA Astrophysics Data System (ADS)

    Li, Hong; Wu, Yang; Ge, Yunsheng; Jiang, Jia; Gao, Kai; Zhang, Pengyun; Wu, Lingxiang; Chen, Shiyi

    2011-09-01

    The purpose of this study was to determine the effect of the combination of hydroxyapatite (HA) and bioglass (BG) on polyethylene terephthalate (PET) artificial ligament graft osseointegration within the bone tunnel. The results of in vitro culturing of MC3T3-E1 mouse osteoblastic cells proved that this HA/BG composite coating can promote the cell compatibility of grafts. A rabbit extraarticular tendon-to-bone healing model was used to evaluate the effect of this composite coating on PET artificial ligaments in vivo. The final results demonstrated that HA/BG coating improved new bone formation at the graft-bone interface and increased the load-to-failure property of graft in bone tunnel compared to the control group at early time. The study has shown that HA/BG composite coating on the PET artificial ligament surface has a positive effect in the induction of artificial ligament osseointegration within the bone tunnel.

  16. In Vivo Models for the Evaluation of the Osteogenic Potency of Bone Substitutes Seeded with Mesenchymal Stem Cells of Human Origin: A Concise Review.

    PubMed

    Westhauser, Fabian; Senger, Anne-Sophie; Reible, Bruno; Moghaddam, Arash

    2017-09-01

    Research concerning bone substitutes is one of the most challenging fields in orthopedic research and has a high clinical relevance, especially since the currently available bone substitutes are limited in their osteostimulative capabilities. In vitro models for the evaluation of the properties of bone substitutes allow the use of human mesenchymal stem cells (hMSCs) seeded onto scaffolds, but suffer from the lack of a physiological environment for those cells. Most in vivo models include the use of non-hMSC and are therefore lacking in clinical relevance. To overcome these issues, in vivo models were created that allow the evaluation of hMSC-seeded bone substitutes, combining the advantages of the use of human cells with the physiological conditions of an organism in vivo. In brief, models usually aim for bone formation in immunocompromised rodents. The subcutaneous implantation of scaffolds is most widely performed, showing low complication rates along with good results, but suffering from inferior vascularization of the implants and the absence of the realistic structural and mechanical conditions of bone. Orthotopic implantation, for example in calvarian or long bone defects, provides the most appropriate surrounding for hMSC-seeded scaffolds. However, parallel host-induced bone formation is a major limitation. This review summarizes in vivo models for the evaluation of the osteogenic potency of bone substitutes seeded with mesenchymal stem cells of human origin.

  17. Novel approach to the fabrication of an artificial small bone using a combination of sponge replica and electrospinning methods

    NASA Astrophysics Data System (ADS)

    Kim, Yang-Hee; Lee, Byong-Taek

    2011-06-01

    In this study, a novel artificial small bone consisting of ZrO2-biphasic calcium phosphate/polymethylmethacrylate-polycaprolactone-hydroxyapatite (ZrO2-BCP/PMMA-PCL-HAp) was fabricated using a combination of sponge replica and electrospinning methods. To mimic the cancellous bone, the ZrO2/BCP scaffold was composed of three layers, ZrO2, ZrO2/BCP and BCP, fabricated by the sponge replica method. The PMMA-PCL fibers loaded with HAp powder were wrapped around the ZrO2/BCP scaffold using the electrospinning process. To imitate the Haversian canal region of the bone, HAp-loaded PMMA-PCL fibers were wrapped around a steel wire of 0.3 mm diameter. As a result, the bundles of fiber wrapped around the wires imitated the osteon structure of the cortical bone. Finally, the ZrO2/BCP scaffold was surrounded by HAp-loaded PMMA-PCL composite bundles. After removal of the steel wires, the ZrO2/BCP scaffold and bundles of HAp-loaded PMMA-PCL formed an interconnected structure resembling the human bone. Its diameter, compressive strength and porosity were approximately 12 mm, 5 MPa and 70%, respectively, and the viability of MG-63 osteoblast-like cells was determined to be over 90% by the MTT (3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide) assay. This artificial bone shows excellent cytocompatibility and is a promising bone regeneration material.

  18. Engineering interaction between bone marrow derived endothelial cells and electrospun surfaces for artificial vascular graft applications.

    PubMed

    Ahmed, Furqan; Dutta, Naba K; Zannettino, Andrew; Vandyke, Kate; Choudhury, Namita Roy

    2014-04-14

    The aim of this investigation was to understand and engineer the interactions between endothelial cells and the electrospun (ES) polyvinylidene fluoride-co-hexafluoropropylene (PVDF-HFP) nanofiber surfaces and evaluate their potential for endothelialization. Elastomeric PVDF-HFP samples were electrospun to evaluate their potential use as small diameter artificial vascular graft scaffold (SDAVG) and compared with solvent cast (SC) PVDF-HFP films. We examined the consequences of fibrinogen adsorption onto the ES and SC samples for endothelialisation. Bone marrow derived endothelial cells (BMEC) of human origin were incubated with the test and control samples and their attachment, proliferation, and viability were examined. The nature of interaction of fibrinogen with SC and ES samples was investigated in detail using ELISA, XPS, and FTIR techniques. The pristine SC and ES PVDF-HFP samples displayed hydrophobic and ultrahydrophobic behavior and accordingly, exhibited minimal BMEC growth. Fibrinogen adsorbed SC samples did not significantly enhance endothelial cell binding or proliferation. In contrast, the fibrinogen adsorbed electrospun surfaces showed a clear ability to modulate endothelial cell behavior. This system also represents an ideal model system that enables us to understand the natural interaction between cells and their extracellular environment. The research reported shows potential of ES surfaces for artificial vascular graft applications.

  19. Artificial neural network assessment of substitutive pharmacological treatments in hospitalised intravenous drug users.

    PubMed

    Grassi, M C; Caricati, A M; Intraligi, M; Buscema, M; Nencini, P

    2002-01-01

    Artificial neural networks (ANNs) provide better solutions than linear discriminant analysis (LDA) to problems of classification and estimation involving a large number of non-homogeneous (categorical and metric) variables. In this study, we compared the ability of traditional LDA and a feed-forward back-propagation (FF-BP) ANN with self-momentum to predict pharmacological treatments received by intravenous drug users (IDUs) hospitalised for coexisting medical illness. When medical staff considered detoxification appropriate they usually suggested methadone (MET) and (or) benzodiazepines (BDZ). Given four different treatment options (MET, BDZ, MET+BDZ, no treatment) as dependent variables and 38 independent variables, the FF-BP ANN provided the best prediction of the consultant's decision (overall accuracy: 62.7%). It achieved the highest level of predictive accuracy for the BDZ option (90.5%), the lowest for no treatment (29.6), often misclassifying no treatment as BDZ. The LDA yielded a lower mean accuracy (50.3%). When the untreated group was excluded, ANN improved its absolute recognition rate by only 1.2% and the BDZ group remained the best predicted. In contrast, LDA improved its absolute recognition rate from 50.3 to 58.9%, maximum 65.7% for the BDZ group. In conclusion, the FF-BP ANN was more accurate than the statistical model (discriminant analysis) in predicting the pharmacological treatment of IDUs.

  20. Bacterial cellulose membranes used as artificial substitutes for dural defection in rabbits.

    PubMed

    Xu, Chen; Ma, Xia; Chen, Shiwen; Tao, Meifeng; Yuan, Lutao; Jing, Yao

    2014-06-16

    To improve the efficacy and safety of dural repair in neurosurgical procedures, a new dural material derived from bacterial cellulose (BC) was evaluated in a rabbit model with dural defects. We prepared artificial dura mater using bacterial cellulose which was incubated and fermented from Acetobacter xylinum. The dural defects of the rabbit model were repaired with BC membranes. All surgeries were performed under sodium pentobarbital anesthesia, and all efforts were made to minimize suffering. All animals were humanely euthanized by intravenous injection of phenobarbitone, at each time point, after the operation. Then, the histocompatibility and inflammatory effects of BC were examined by histological examination, real-time fluorescent quantitative polymerase chain reaction (PCR) and Western Blot. BC membranes evenly covered the surface of brain without adhesion. There were seldom inflammatory cells surrounding the membrane during the early postoperative period. The expression of inflammatory cytokines IL-1β, IL-6 and TNF-α as well as iNOS and COX-2 were lower in the BC group compared to the control group at 7, 14 and 21 days after implantation. BC can repair dural defects in rabbit and has a decreased inflammatory response compared to traditional materials. However, the long-term effects need to be validated in larger animals.

  1. Bacterial Cellulose Membranes Used as Artificial Substitutes for Dural Defection in Rabbits

    PubMed Central

    Xu, Chen; Ma, Xia; Chen, Shiwen; Tao, Meifeng; Yuan, Lutao; Jing, Yao

    2014-01-01

    To improve the efficacy and safety of dural repair in neurosurgical procedures, a new dural material derived from bacterial cellulose (BC) was evaluated in a rabbit model with dural defects. We prepared artificial dura mater using bacterial cellulose which was incubated and fermented from Acetobacter xylinum. The dural defects of the rabbit model were repaired with BC membranes. All surgeries were performed under sodium pentobarbital anesthesia, and all efforts were made to minimize suffering. All animals were humanely euthanized by intravenous injection of phenobarbitone, at each time point, after the operation. Then, the histocompatibility and inflammatory effects of BC were examined by histological examination, real-time fluorescent quantitative polymerase chain reaction (PCR) and Western Blot. BC membranes evenly covered the surface of brain without adhesion. There were seldom inflammatory cells surrounding the membrane during the early postoperative period. The expression of inflammatory cytokines IL-1β, IL-6 and TNF-α as well as iNOS and COX-2 were lower in the BC group compared to the control group at 7, 14 and 21 days after implantation. BC can repair dural defects in rabbit and has a decreased inflammatory response compared to traditional materials. However, the long-term effects need to be validated in larger animals. PMID:24937688

  2. Use of Metallic Endosseous Implants as a Tooth Substitute

    DTIC Science & Technology

    1975-11-25

    REPORT NUMBER 4 USE OF METALLIC ENDOSSEOUS IMPLANTS AS A TOOTH SUBSTITUTE ANNUAL REPORT Marvin B. Weiss, D.D.S., and William Rostoker, PhD. November...70-C-0114 USE OF METALLIC ENDOSSEOUS IMPLANTS AS A TOOTH SUBSTITUTE INTRODUCTION: OBJECTIVE The object of the study is to evaluate the viability of an...artificial metallic prosthesis as a tooth replacement when placed permanently in- to the jaw bone. The tooth substitute consists of two parts; (1) the

  3. Multinucleated giant cells in the implant bed of bone substitutes are foreign body giant cells-New insights into the material-mediated healing process.

    PubMed

    Barbeck, Mike; Booms, Patrick; Unger, Ronald; Hoffmann, Verena; Sader, Robert; Kirkpatrick, Charles James; Ghanaati, Shahram

    2017-04-01

    In addition to macrophages, multinucleated giant cells (MNGCs) are involved in the tissue reaction to a variety of biomaterials. Especially in the case of bone substitute materials it has been assumed that the MNGCs are osteoclasts, based on the chemical and physical similarity of many materials to the calcified matrix and the bony environment in which they are used. However, many studies indicate that these cells belong to the cell line of the foreign body giant cells (FBGCs), which are of "inflammatory origin", although they have been shown to possess both a pro- and also anti-inflammatory phenotype. Moreover, no information is available about their role in the tissue reaction to bone substitute materials. The present study was conducted to analyze the origin of MNGCs in the implant beds of a synthetic and a xenogeneic bone substitute and focused on the application of immunohistochemical methods. Two antibodies against integrin molecules specific for osteoclasts (β-3 integrin) or FBGCs (β-2 integrin) were used to distinguish both giant cell types. The results of the present study indicate that the MNGCs induced by both kinds of bone substitutes are FBGCs, as they express only β-2 integrin in contrast to the osteoclasts outside of the immediate implantation areas, which only demonstrate β-3 integrin expression. These data give new insight into the tissue reaction to both xenogeneic and synthetic bone substitutes. Based on this new knowledge further research concerning the proteomic profile of the FBGCs especially based on the different physicochemical properties of bone substitutes is necessary. This may show that specific characteristics of bone substitutes may exhibit a substantial influence on the regeneration process via the expression of anti-inflammatory molecules by FBGCs. Based on this information it may be possible to formulate and choose bone substitutes that can guide the process of bone tissue regeneration on the molecular level. © 2017 Wiley

  4. Alveolar ridge preservation with the socket-plug technique utilizing an alloplastic putty bone substitute or a particulate xenograft: a histological pilot study.

    PubMed

    Mahesh, Lanka; Venkataraman, Narayan; Shukla, Sagrika; Prasad, Hari; Kotsakis, Georgios A

    2015-04-01

    Following tooth extraction, ridge preservation procedures are employed to regenerate bone in the extraction socket, limit consequent ridge resorption, and provide a stable base for implant placement. The purpose of this study is to histologically evaluate and compare bone regeneration in extraction sockets grafted with either a putty alloplastic bone substitute or particulate anorganic bovine xenograft utilizing the socket-plug technique. Nineteen patients underwent 20 tooth extractions and ridge preservation following a standardized protocol. Ten sites were grafted with calcium phosphosilicate putty (CPS group) and the remaining 10 with anorganic bovine bone substitute (BO group). Patients were recalled after 4-6 months to evaluate the bone regeneration and to proceed with implant placement. A bone core was obtained during the implant procedure from each site and was used for histologic analysis. Histomorphometry revealed that residual graft values were significantly higher in the BO group (25.60% ± 5.89%) compared to the CPS group (17.40% ± 9.39%) (P < .05). The amount of new bone regenerated was also statistically significant higher in the alloplast group (47.15% ± 8.5%) as compared to the xenograft group (22.2% ± 3.5%) (P < .05). Results suggest that ridge preservation using a putty calcium phosphosilicate alloplastic bone substitute demonstrates more timely graft substitution and increased bone regeneration when compared to an anorganic bovine bone xenograft.

  5. IN VIVO PERFORMANCE OF THE EXPERIMENTAL CHITOSAN BASED BONE SUBSTITUTE--ADVANCED THERAPY MEDICINAL PRODUCT. A STUDY IN SHEEP.

    PubMed

    Bojar, Witold; Kucharska, Martyna; Ciach, Tomasz; Paśnik, Iwona; Korobowicz, Elzbieta; Patkowski, Krzysztof; Gruszecki, Tomasz; Szymanowski, Marek; Rzodkiewicz, Przemysław

    2016-01-01

    When evaluating a novel bone substitute material, advanced in vivo testing is an important step in development and safety affirmation. Sheep seems to be a valuable model for human bone turnover and remodeling activity. The experimental material composed with the stem cells is an advanced therapy medicinal product (acc. to EC Regulation 1394/2007). Our research focuses on histological differences in bone formation (guided bone regeneration--GBR) in sheep maxillas after implantation of the new chitosan/tricalcium phosphate/alginate (CH/TCP/Alg) biomaterial in comparison to the commercially available xenogenic bone graft and a/m enhanced with the stem cells isolated from the adipose tissue. Twelve adult female sheep of BCP synthetic line, weighing 60-70 kg were used for the study. The 11 mm diameter defects in maxilla bone were prepared with a trephine bur under general anesthesia and then filled with the bone substitute materials: CH/TCP/Alg, BioOss Collagen, Geistlich AG (BO), CH/TCP/Alg composed with the stem cells (CH/S) or left just with the blood clot (BC). Inbreeding cycle of the animals terminated at 4 months after surgery. Dissected specimens of the maxilla were evaluated histologically and preliminary under microtomography. Histological evaluation showed early new bone formation observed around the experimental biomaterial and commercially available BO. There were no features of purulent inflammation and necrosis, or granulomatous inflammation. Microscopic examination after 4 months following the surgery revealed trabecular bone formation around chitosan based bone graft and xenogenic material with no significant inflammatory response. Different results--no bone recreation were observed for the negative control (BC). In conclusion, the tested materials (CH/TCP/Alg and BO) showed a high degree of biocompatibility and some osteoconductivity in comparison with the control group. Although the handiness, granules size and setting time of CHffCP/Alg may be refined

  6. Histological assessment of augmented jaw bone utilizing a new collagen barrier membrane compared to a standard barrier membrane to protect a granular bone substitute material.

    PubMed

    Friedmann, Anton; Strietzel, Frank Peter; Maretzki, Burghard; Pitaru, Sandu; Bernimoulin, Jean-Pierre

    2002-12-01

    Successful bone augmentation requires predictable space maintenance and adequate exclusion of those cells that lack osteogenetic potential from the defect area. Natural bone mineral is considered to be osteoconductive and is used as space maker in combination with membrane barrier techniques. The aim of this study was to compare qualitative histological results achieved by using deproteinized bovine bone mineral (DBBM) as a space maintainer and a new collagen barrier (Ossix, test group) vs. the same bone substitute and the standard e-PTFE membrane (Gore-Tex), control group). Twenty-eight patients were randomly assigned to the test or the control group. Seven months after augmentation procedures, biopsies were obtained at reentry and were analysed histomorphometrically. In all, 14 specimens of group I (test group, Ossix) and 13 specimens of group II (controls, PTFE-membranes) showed close qualitative similarity of their histologies. Histomorphometrically, total mineralized bone area was 42% +/- 18% in group I vs. 39% +/- 15% in group II. The unmineralized tissue area was 44% +/- 15% vs. 46% +/- 12% and the area of DBBM remnants 14% +/- 9% and 15% +/- 12%, respectively. The differences were statistically nonsignificant (Mann-Whitney test). The occurrence of barrier exposure did not interfere with the histological outcome either in the test or in the control group. The new collagen barrier combined with the DBBM provided qualitative bone regeneration comparable to the standard e-PTFE material combined with the same mineral.

  7. Synthetic bone substitute material comparable with xenogeneic material for bone tissue regeneration in oral cancer patients: First and preliminary histological, histomorphometrical and clinical results

    PubMed Central

    Ghanaati, Shahram; Barbeck, Mike; Lorenz, Jonas; Stuebinger, Stefan; Seitz, Oliver; Landes, Constantin; Kovács, Adorján F.; Kirkpatrick, Charles J.; Sader, Robert A.

    2013-01-01

    Background: The present study was first to evaluate the material-specific cellular tissue response of patients with head and neck cancer to a nanocrystalline hydroxyapatite bone substitute NanoBone (NB) in comparison with a deproteinized bovine bone matrix Bio-Oss (BO) after implantation into the sinus cavity. Materials and Methods: Eight patients with tumor resection for oral cancer and severely resorbed maxillary bone received materials according to a split mouth design for 6 months. Bone cores were harvested prior to implantation and analyzed histologically and histomorphometrically. Implant survival was followed-up to 2 years after placement. Results: Histologically, NB underwent a higher vascularization and induced significantly more tartrate-resistant acid phosphatase-positive (TRAP-positive) multinucleated giant cells when compared with BO, which induced mainly mononuclear cells. No significant difference was observed in the extent of new bone formation between both groups. The clinical follow-up showed undisturbed healing of all implants in the BO-group, whereas the loss of one implant was observed in the NB-group. Conclusions: Within its limits, the present study showed for the first time that both material classes evaluated, despite their induction of different cellular tissue reactions, may be useful as augmentation materials for dental and maxillofacial surgical applications, particularly in patients who previously had oral cancer. PMID:24205471

  8. Evaluation of bone regeneration with biphasic calcium phosphate substitute implanted with bone morphogenetic protein 2 and mesenchymal stem cells in a rabbit calvarial defect model.

    PubMed

    Kim, Beom-Su; Choi, Moon-Ki; Yoon, Jung-Hoon; Lee, Jun

    2015-07-01

    The aim of this study was to evaluate the in vivo osteogenic potential of biphasic calcium phosphate (BCP), bone morphogenetic protein 2 (BMP-2), and/or mesenchymal stem cell (MSC) composites by using a rabbit calvarial defect model. Bone formation was assessed by using three different kinds of implants in rabbit calvarial defects, BCP alone, BCP/recombinant human (rh) BMP-2, and BCP/rhBMP-2/MSCs composite. The implants were harvested after 2 or 8 weeks, and the area of new bone formation was quantified by micro-computed tomography (micro-CT) and histologic studies. The highest bone formation was achieved with the BCP/rhBMP-2/MSCs treatment, and it was significantly higher than that achieved with the empty or BCP-alone treatment. The quantity of new bone at 8 weeks was greater than at 4 weeks in each group. The relative density of osteocalcin immunoreactivity also increased during this interval. These results indicate that the combination of BCP, rhBMP-2, and MSCs synergistically enhances osteogenic potential during the early healing period and could be used as a bone graft substitute. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Synthetic bone substitute material comparable with xenogeneic material for bone tissue regeneration in oral cancer patients: First and preliminary histological, histomorphometrical and clinical results.

    PubMed

    Ghanaati, Shahram; Barbeck, Mike; Lorenz, Jonas; Stuebinger, Stefan; Seitz, Oliver; Landes, Constantin; Kovács, Adorján F; Kirkpatrick, Charles J; Sader, Robert A

    2013-07-01

    The present study was first to evaluate the material-specific cellular tissue response of patients with head and neck cancer to a nanocrystalline hydroxyapatite bone substitute NanoBone (NB) in comparison with a deproteinized bovine bone matrix Bio-Oss (BO) after implantation into the sinus cavity. Eight patients with tumor resection for oral cancer and severely resorbed maxillary bone received materials according to a split mouth design for 6 months. Bone cores were harvested prior to implantation and analyzed histologically and histomorphometrically. Implant survival was followed-up to 2 years after placement. Histologically, NB underwent a higher vascularization and induced significantly more tartrate-resistant acid phosphatase-positive (TRAP-positive) multinucleated giant cells when compared with BO, which induced mainly mononuclear cells. No significant difference was observed in the extent of new bone formation between both groups. The clinical follow-up showed undisturbed healing of all implants in the BO-group, whereas the loss of one implant was observed in the NB-group. Within its limits, the present study showed for the first time that both material classes evaluated, despite their induction of different cellular tissue reactions, may be useful as augmentation materials for dental and maxillofacial surgical applications, particularly in patients who previously had oral cancer.

  10. Ice crystal patterns in artificial gels of extracellular matrix macromolecules after quick-freezing and freeze-substitution.

    PubMed

    Allenspach, A L; Kraemer, T G

    1989-04-01

    Artificial gels, composed of collagen with or without hyaluronate (HA), a glycosaminoglycan (GAG), and chondroitin sulfate (CS), were prepared and quick-frozen for the purpose of studying the influence of composition and concentration on ice patterns. Dilute gels were spread on coverslips, plunged into a slush of 30% isopentane/70% propane (-185 degrees C), freeze-substituted, and examined by phase-contrast microscopy. Ice patterns were revealed as "ice cavities" in the gel after freeze-substitution. Ice morphology in the gels was gel-type-specific, suggesting that composition in dilute gels can influence ice pattern formation. Crystallization patterns reflecting high, intermediate, and low rates of freezing were observed in all gel types. Intermediate freezing in differentiating gel-type-specific ice patterns. Gels which included hyaluronate (HA) and chondroitin sulfate (CS) altered the ice crystal pattern commonly observed in collagen gels. Ice structure in collagen gels consisted predominantly of long, parallel crystals in the herringbone pattern. Ice crystals separated gel into thin, unbranched fibers with a primary spacing of approximately 2 microns. Ice morphology in HA gels formed a mosaic consisting of packets of ice crystals. Contiguous packets were often oriented at right angles to each other. Periodic crossbridges interconnect primary gel fibers of HA gels and interrupt the lengthwise growth of ice crystals. Smooth beads were visible on primary strands in HA gels frozen at intermediate velocities. The addition of CS to collagen gels resulted in formation of randomly oriented ice crystals in gels frozen at intermediate rates. CS has little influence on ice morphology at low freezing velocities. Primary strands in CS gels were decorated with rough-surfaced, osmiophilic aggregates.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Artificial Polymeric Scaffolds as Extracellular Matrix Substitutes for Autologous Conjunctival Goblet Cell Expansion

    PubMed Central

    He, Min; Storr-Paulsen, Thomas; Wang, Annie L.; Ghezzi, Chiara E.; Wang, Siran; Fullana, Matthew; Karamichos, Dimitrios; Utheim, Tor P.; Islam, Rakibul; Griffith, May; Islam, M. Mirazul; Hodges, Robin R.; Wnek, Gary E.; Kaplan, David L.; Dartt, Darlene A.

    2016-01-01

    Purpose We fabricated and investigated polymeric scaffolds that can substitute for the conjunctival extracellular matrix to provide a substrate for autologous expansion of human conjunctival goblet cells in culture. Methods We fabricated two hydrogels and two silk films: (1) recombinant human collagen (RHC) hydrogel, (2) recombinant human collagen 2-methacryloylxyethyl phosphorylcholine (RHC-MPC) hydrogel, (3) arginine-glycine-aspartic acid (RGD) modified silk, and (4) poly-D-lysine (PDL) coated silk, and four electrospun scaffolds: (1) collagen, (2) poly(acrylic acid) (PAA), (3) poly(caprolactone) (PCL), and (4) poly(vinyl alcohol) (PVA). Coverslips and polyethylene terephthalate (PET) were used for comparison. Human conjunctival explants were cultured on scaffolds for 9 to 15 days. Cell viability, outgrowth area, and the percentage of cells expressing markers for stratified squamous epithelial cells (cytokeratin 4) and goblet cells (cytokeratin 7) were determined. Results Most of cells grown on all scaffolds were viable except for PCL in which only 3.6 ± 2.2% of the cells were viable. No cells attached to PVA scaffold. The outgrowth was greatest on PDL-silk and PET. Outgrowth was smallest on PCL. All cells were CK7-positive on RHC-MPC while 84.7 ± 6.9% of cells expressed CK7 on PDL-silk. For PCL, 87.10 ± 3.17% of cells were CK7-positive compared to PET where 67.10 ± 12.08% of cells were CK7-positive cells. Conclusions Biopolymer substrates in the form of hydrogels and silk films provided for better adherence, proliferation, and differentiation than the electrospun scaffolds and could be used for conjunctival goblet cell expansion for eventual transplantation once undifferentiated and stratified squamous cells are included. Useful polymer scaffold design characteristics have emerged from this study. PMID:27832279

  12. Clinical effectiveness of combining platelet rich fibrin with alloplastic bone substitute for the management of combined endodontic periodontal lesion.

    PubMed

    Goyal, Lata

    2014-02-01

    The term "endo-perio" lesion has been proposed to describe the destructive lesion resulting from inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. In most of the cases, clinical symptoms disappear following successful endodontic therapy. However failure after conventional root canal treatment calls for surgical intervention. A 35 year old male patient with endo-perio lesion in right maxillary lateral incisor was treated with platelet rich fibrin (PRF) and alloplastic bone substitute after conventional endodontic therapy. At the end of 6 months there was gain in clinical attachment, increased radiographic bone fill and reduction in probing depth which was maintained till 18 month follow-up. Present case report aims to evaluate the efficacy of PRF and alloplastic bone substitute in the management of intrabony defect associated with endo-perio lesion in maxillary lateral incisor because the healing potential of PRF and bone graft has not been widely studied in endodontics. The use of PRF allows the clinician to optimize tissue remodelling, wound healing and angiogenesis by the local delivery of growth factors and proteins. The novel technique described here enables the clinician to be benefited from the full regenerative capacity of this autologous biologic material.

  13. Use of mineralized collagen bone graft substitutes and dorsal locking plate in treatment of elder metaphyseal comminuted distal radius fracture

    NASA Astrophysics Data System (ADS)

    Liu, Ke-Bin; Huang, Kui; Teng, Yu; Qu, Yan-Zheng; Cui, Wei; Huang, Zhen-Fei; Sun, Ting-Fang; Guo, Xiao-Dong

    2014-03-01

    Bone graft may be needed to fill bone defect in elderly patients with a metaphyseal comminuted distal radius fracture. In this retrospective, nonrandomized, single-surgeon study, we evaluated the clinical and radiologic outcomes of using both dorsal locking plates with or without augmentation with mineralized collagen (MC) bone graft for elderly patients with dorsally metaphyseal comminuted radius fractures. Patients in group 1 ( n = 12) were treated with dorsal locking plates with MC bone graft application into the metaphyseal bone defect, and those in group 2 ( n = 12) only with dorsal locking plates. Clinical and radiologic parameters were determined at three and 12 months after surgery. At final follow-up, no significant difference was noted between the 2 groups in terms of palmar tilt and radial inclination ( p = 0.80); however, ulnar variance increased significantly in the group 2 treated with dorsal locking plates without augmentation ( p < 0.05). Functionally, there was no significant difference between the groups. Our preliminary study suggests that combination of MC as bone-graft substitutes and dorsal locking plates may be a usefully alternative for elderly patients with metaphyseal comminuted distal radius fracture.

  14. Efficacy of a small cell-binding peptide coated hydroxyapatite substitute on bone formation and implant fixation in sheep.

    PubMed

    Ding, Ming; Andreasen, Christina M; Dencker, Mads L; Jensen, Anders E; Theilgaard, Naseem; Overgaard, Søren

    2015-04-01

    Cylindrical critical size defects were created at the distal femoral condyles bilaterally of eight female adult sheep. Titanium implants with 2-mm concentric gaps were inserted and the gaps were filled with one of the four materials: allograft; a synthetic 15-amino acid cell-binding peptide coated hydroxyapatite (ABM/P-15); hydroxyapatite + βtricalciumphosphate+ Poly-Lactic-Acid (HA/βTCP-PDLLA); or ABM/P-15+HA/βTCP-PDLLA. After nine weeks, bone-implant blocks were harvested and sectioned for micro-CT scanning, push-out test, and histomorphometry. Significant bone formation and implant fixation could be observed in all four groups. Interestingly, the microarchitecture of the ABM/P-15 group was significantly different from the control group. Tissue volume fraction and thickness were significantly greater in the ABM/P-15 group than in the allograft group. Bone formation and bone ingrowth to porous titanium implant were not significantly different among the four groups. The ABM/P-15 group had similar shear mechanical properties on implant fixation as the allograft group. Adding HA/βTCP-PDLLA to ABM/P-15 did not significantly change these parameters. This study revealed that ABM/P-15 had significantly bone formation in concentric gap, and its enhancements on bone formation and implant fixation were at least as good as allograft. It is suggested that ABM/P-15 might be a good alternative biomaterial for bone implant fixation in this well-validated critical-size defect gap model in sheep. Nevertheless, future clinical researches should focus on prospective, randomized, controlled trials in order to fully elucidate whether ABM/P-15 could be a feasible candidate for bone substitute material in orthopedic practices.

  15. Sinus Floor Augmentation Comparing an In Situ Hardening Biphasic Calcium Phosphate (Hydroxyapatite/β-Tricalcium Phosphate) Bone Graft Substitute with a Particulate Biphasic Calcium Phosphate (Hydroxyapatite/β-Tricalcium Phosphate) Bone Graft Substitute: An Experimental Study in Sheep.

    PubMed

    Wildburger, Angelika; Bubalo, Vladimir; Magyar, Marton; Nagursky, Heiner; Jakse, Norbert; Schmelzeisen, Rainer; Sauerbier, Sebastian

    2017-07-01

    The aim of the present split-mouth study in sheep was to assess the influence of in situ hardening properties of a biphasic calcium phosphate (BCP) bone graft substitute (BGS) (ratio hydroxyapatite/β-tricalcium phosphate = 60/40) compared with a particulate BGS with the same biphasic core-granule composition without in situ hardening properties on sinus floor augmentation. Therefore, bilateral sinus floor augmentation was performed in eight sheep. Poly(lactide-co-glycolide) (PLGA)-coated, in situ hardening biphasic BGS (PLGA-NMP [N-Methyl-2-pyrrolidone]-BCP) was placed at the test site, and a particulate biphasic BGS without PLGA coating (BCP) was used for the contralateral site as a control. Animals were sacrificed after 21 weeks. Sinus augmentation sites were analyzed histologically. The volume was analyzed by computed tomography. Histomorphometric parameters were assessed for the 12 and 21 weeks' time points. Slopes of new bone formation over time were compared with a linear growth regression model. Bone formation after 12 and 21 weeks of healing was 8.94% (±3.74) and 19.82% (±6.29) for PLGA-NMP-BCP and 7.00% (±2.58) and 14.38% (±4.51) for BCP, respectively. The bone growth rate for PLGA-NMP-BCP was higher than the growth rate for BCP (probability 97.5%). The total fraction of calcified hard tissue (% bone fraction + % biomaterial) was around 46% for both tested biomaterials, 21 weeks after sinus floor augmentation. The in situ hardening BGS (PLGA-NMP-BCP) performed better than the particulate material (BCP) in terms of bone formation rate. The in situ hardening properties of the PLGA-NMP-BCP material mediated by the PLGA coating and NMP solution as plasticizer had no negative influence on the bone formation.

  16. Hard tissue regeneration using bone substitutes: an update on innovations in materials

    PubMed Central

    Sarkar, Swapan Kumar

    2015-01-01

    Bone is a unique organ composed of mineralized hard tissue, unlike any other body part. The unique manner in which bone can constantly undergo self-remodeling has created interesting clinical approaches to the healing of damaged bone. Healing of large bone defects is achieved using implant materials that gradually integrate with the body after healing is completed. Such strategies require a multidisciplinary approach by material scientists, biological scientists, and clinicians. Development of materials for bone healing and exploration of the interactions thereof with the body are active research areas. In this review, we explore ongoing developments in the creation of materials for regenerating hard tissues. PMID:25995658

  17. Synchrotron μCT imaging of bone, titanium implants and bone substitutes - a systematic review of the literature.

    PubMed

    Neldam, Camilla Albeck; Pinholt, Else Marie

    2014-09-01

    Today X-ray micro computer tomography (μCT) imaging is used to investigate bone microarchitecture. μCT imaging is obtained by polychromatic X-ray beams, resulting in images with beam hardening artifacts, resolution levels at 10 μm, geometrical blurring, and lack of contrasts. When μCT is coupled to synchrotron sources (SRμCT) a spatial resolution up to one tenth of a μm may be achieved. A review of the literature concerning SRμCT was performed to investigate its usability and its strength in visualizing fine bone structures, vessels, and microarchitecture of bone. Although mainly limited to in vitro examinations, SRμCT is considered as a gold standard to image trabecular bone microarchitecture since it is possible in a 3D manner to visualize fine structural elements within mineralized tissue such as osteon boundaries, rods and plates structures, cement lines, and differences in mineralization.

  18. Autologous serum improves bone formation in a primary stable silica-embedded nanohydroxyapatite bone substitute in combination with mesenchymal stem cells and rhBMP-2 in the sheep model

    PubMed Central

    Boos, Anja M; Weigand, Annika; Deschler, Gloria; Gerber, Thomas; Arkudas, Andreas; Kneser, Ulrich; Horch, Raymund E; Beier, Justus P

    2014-01-01

    New therapeutic strategies are required for critical size bone defects, because the gold standard of transplanting autologous bone from an unharmed area of the body often leads to several severe side effects and disadvantages for the patient. For years, tissue engineering approaches have been seeking a stable, axially vascularized transplantable bone replacement suitable for transplantation into the recipient bed with pre-existing insufficient conditions. For this reason, the arteriovenous loop model was developed and various bone substitutes have been vascularized. However, it has not been possible thus far to engineer a primary stable and axially vascularized transplantable bone substitute. For that purpose, a primary stable silica-embedded nanohydroxyapatite (HA) bone substitute in combination with blood, bone marrow, expanded, or directly retransplanted mesenchymal stem cells, recombinant human bone morphogenetic protein 2 (rhBMP-2), and different carrier materials (fibrin, cell culture medium, autologous serum) was tested subcutaneously for 4 or 12 weeks in the sheep model. Autologous serum lead to an early matrix change during degradation of the bone substitute and formation of new bone tissue. The best results were achieved in the group combining mesenchymal stem cells expanded with 60 μg/mL rhBMP-2 in autologous serum. Better ingrowth of fibrovascular tissue could be detected in the autologous serum group compared with the control (fibrin). Osteoclastic activity indicating an active bone remodeling process was observed after 4 weeks, particularly in the group with autologous serum and after 12 weeks in every experimental group. This study clearly demonstrates the positive effects of autologous serum in combination with mesenchymal stem cells and rhBMP-2 on bone formation in a primary stable silica-embedded nano-HA bone grafting material in the sheep model. In further experiments, the results will be transferred to the sheep arteriovenous loop model in

  19. Influence of saliva substitute films on the initial adhesion of Candida albicans to dental substrata prior to and after artificial ageing.

    PubMed

    Hahnel, Sebastian; Ettl, Tobias; Gosau, Martin; Rosentritt, Martin; Handel, Gerhard; Bürgers, Ralf

    2010-05-01

    The aim of this in vitro study was to investigate whether saliva substitute films influence the adhesion of Candida albicans to different dental substrata prior to and after artificial ageing. Specimens of a denture base resin (DB) and a veneering composite (VC) were polished and subjected to an artificial ageing protocol (thermal cycling, 2 x 3000 cycles 5/55 degrees C). Bovine enamel (BE) and glass were used as reference materials. After determination of surface free energy, specimens were rinsed with commercial saliva substitutes (Aldiamed, Saliva natura, Saliva Orthana, Salinum), a positive control (protein mixture), or a negative control (Phosphate Buffered Saline, PBS) for 2h at 37 degrees C in a flow chamber. Specimens were then exposed to a C. albicans ATCC 10231 suspension for 4h at 37 degrees C. Adherent, viable Candida cells were quantified using a luminometric ATP-based assay. Statistical analysis was performed using 1- and 2-way ANOVA, and post-hocs were analysed using the Tukey-Kramer test (alpha<.05). Our data indicated that VC (31.1 mJ/m2) and DB (33.9 mJ/m2) yielded the lowest surface free energy prior to artificial ageing, and BE (43.6 mJ/m2) yielded the highest surface free energy. For C. albicans adhesion, both the materials as well as the saliva substitutes influenced relative luminescence intensities, indicating significant differences in C. albicans adhesion between the various materials and after treatment with the saliva substitutes. Saliva substitutes may have a decisive influence on C. albicans adhesion, but their impact appears to be dependent on the properties of the underlying substratum material. Copyright 2010 Elsevier Ltd. All rights reserved.

  20. Long-term bony integration and resorption kinetics of a xenogeneic bone substitute after sinus floor augmentation: histomorphometric analyses of human biopsy specimens.

    PubMed

    Klein, Marcus O; Kämmerer, Peer W; Götz, Hermann; Duschner, Heinz; Wagner, Wilfried

    2013-01-01

    In this case series, a systematic histomorphometric analysis of two human bone biopsy specimens was conducted 1 and 5 years after grafting with a xenogeneic bovine bone substitute material (BSM). While the 1-year specimen still showed extensive signs of an active desmal ossification, the specimen after 5 years mainly showed mature lamellar bone without bone turnover or remodeling. A completed bony integration without extensive resorption of the BSM particles could be detected. Altogether, a good integration in the bone with osteoconduction and a high biocompatibility was seen.

  1. Facilitated receptor-recognition and enhanced bioactivity of bone morphogenetic protein-2 on magnesium-substituted hydroxyapatite surface

    NASA Astrophysics Data System (ADS)

    Huang, Baolin; Yuan, Yuan; Li, Tong; Ding, Sai; Zhang, Wenjing; Gu, Yuantong; Liu, Changsheng

    2016-04-01

    Biomaterial surface functionalized with bone morphogenetic protein-2 (BMP-2) is a promising approach to fabricating successful orthopedic implants/scaffolds. However, the bioactivity of BMP-2 on material surfaces is still far from satisfactory and the mechanism of related protein-surface interaction remains elusive. Based on the most widely used bone-implants/scaffolds material, hydroxyapatite (HAP), we developed a matrix of magnesium-substituted HAP (Mg-HAP, 2.2 at% substitution) to address these issues. Further, we investigated the adsorption dynamics, BMPRs-recruitment, and bioactivity of recombinant human BMP-2 (rhBMP-2) on the HAP and Mg-HAP surfaces. To elucidate the mechanism, molecular dynamic simulations were performed to calculate the preferred orientations, conformation changes, and cysteine-knot stabilities of adsorbed BMP-2 molecules. The results showed that rhBMP-2 on the Mg-HAP surface exhibited greater bioactivity, evidenced by more facilitated BMPRs-recognition and higher ALP activity than on the HAP surface. Moreover, molecular simulations indicated that BMP-2 favoured distinct side-on orientations on the HAP and Mg-HAP surfaces. Intriguingly, BMP-2 on the Mg-HAP surface largely preserved the active protein structure evidenced by more stable cysteine-knots than on the HAP surface. These findings explicitly clarify the mechanism of BMP-2-HAP/Mg-HAP interactions and highlight the promising application of Mg-HAP/BMP-2 matrixes in bone regeneration implants/scaffolds.

  2. A novel injectable, cohesive and toughened Si-HPMC (silanized-hydroxypropyl methylcellulose) composite calcium phosphate cement for bone substitution.

    PubMed

    Liu, Weizhen; Zhang, Jingtao; Rethore, Gildas; Khairoun, Khalid; Pilet, Paul; Tancret, Franck; Bouler, Jean-Michel; Weiss, Pierre

    2014-07-01

    This study reports on the incorporation of the self-setting polysaccharide derivative hydrogel (silanized-hydroxypropyl methylcellulose, Si-HPMC) into the formulation of calcium phosphate cements (CPCs) to develop a novel injectable material for bone substitution. The effects of Si-HPMC on the handling properties (injectability, cohesion and setting time) and mechanical properties (Young's modulus, fracture toughness, flexural and compressive strength) of CPCs were systematically studied. It was found that Si-HPMC could endow composite CPC pastes with an appealing rheological behavior at the early stage of setting, promoting its application in open bone cavities. Moreover, Si-HPMC gave the composite CPC good injectability and cohesion, and reduced the setting time. Si-HPMC increased the porosity of CPCs after hardening, especially the macroporosity as a result of entrapped air bubbles; however, it improved, rather than compromised, the mechanical properties of composite CPCs, which demonstrates a strong toughening and strengthening effect. In view of the above, the Si-HPMC composite CPC may be particularly promising as bone substitute material for clinic application.

  3. Facilitated receptor-recognition and enhanced bioactivity of bone morphogenetic protein-2 on magnesium-substituted hydroxyapatite surface

    PubMed Central

    Huang, Baolin; Yuan, Yuan; Li, Tong; Ding, Sai; Zhang, Wenjing; Gu, Yuantong; Liu, Changsheng

    2016-01-01

    Biomaterial surface functionalized with bone morphogenetic protein-2 (BMP-2) is a promising approach to fabricating successful orthopedic implants/scaffolds. However, the bioactivity of BMP-2 on material surfaces is still far from satisfactory and the mechanism of related protein-surface interaction remains elusive. Based on the most widely used bone-implants/scaffolds material, hydroxyapatite (HAP), we developed a matrix of magnesium-substituted HAP (Mg-HAP, 2.2 at% substitution) to address these issues. Further, we investigated the adsorption dynamics, BMPRs-recruitment, and bioactivity of recombinant human BMP-2 (rhBMP-2) on the HAP and Mg-HAP surfaces. To elucidate the mechanism, molecular dynamic simulations were performed to calculate the preferred orientations, conformation changes, and cysteine-knot stabilities of adsorbed BMP-2 molecules. The results showed that rhBMP-2 on the Mg-HAP surface exhibited greater bioactivity, evidenced by more facilitated BMPRs-recognition and higher ALP activity than on the HAP surface. Moreover, molecular simulations indicated that BMP-2 favoured distinct side-on orientations on the HAP and Mg-HAP surfaces. Intriguingly, BMP-2 on the Mg-HAP surface largely preserved the active protein structure evidenced by more stable cysteine-knots than on the HAP surface. These findings explicitly clarify the mechanism of BMP-2-HAP/Mg-HAP interactions and highlight the promising application of Mg-HAP/BMP-2 matrixes in bone regeneration implants/scaffolds. PMID:27075233

  4. Substitution of osteoporotic alveolar bone by biphasic calcium phosphate/poly-DL-lactide-co-glycolide biomaterials.

    PubMed

    Ajduković, Zorica; Zorica, Ajduković; Ignjatović, Nenad; Nenad, Ignjatović; Petrović, Dragan; Dragan, Petrović; Uskoković, Dragan; Dragan, Uskoković

    2007-01-01

    Lost bone tissue due to osteoporosis makes dentistry very difficult. The aim of thisstudy is to reconstruct the bone tissue with composite biomaterials and to estimate the optical density and alveolar ridge height of the mandible. Research is conducted on 30 postmenopausal women aged from 46 to 62 years, with diagnosed osteoporosis and defects in alveolar bones caused by extraction of paradontopathic teeth, enucleation of cysts and periapical changes, extraction of impacted teeth,or by trauma.Biphasic calcium phosphate/poly-DL-lactide-co-glycolide (BCP/PLGA) composite is implanted into the defects of alveolar bones. Six weeks after implantation of BCP/PLGA, the alveolar bone density in the region of premolars on the experimental side of the jaw is found to be lower than that on the untreated, control, side of the jaw. On thecontrary, 24 weeks after implantation, it is significantly higher compared with the density of the control side. A significant increase in optical density of alveolar bones in the region of premolars on the experimental side compared with the control one is noticed. These results indicate a high level of osteoregeneration and osteoblast activity. Synthetic BCP/PLGA composite belongs to the group of biomaterials, which facilitate formation of new bones and rehabilitation of alveolar bones weakened by osteoporosis. Because of its osteoconductive characteristics, BCP/PLGA composite is supposed to be the material of choice for replacement of bone tissue in the future.

  5. Posterolateral Arthrodesis in Lumbar Spine Surgery Using Autologous Platelet-Rich Plasma and Cancellous Bone Substitute: An Osteoinductive and Osteoconductive Effect

    PubMed Central

    Tarantino, Roberto; Donnarumma, Pasquale; Mancarella, Cristina; Rullo, Marika; Ferrazza, Giancarlo; Barrella, Gianna; Martini, Sergio; Delfini, Roberto

    2014-01-01

    Study Design Prospective cohort study. Objectives To analyze the effectiveness and practicality of using cancellous bone substitute with platelet-rich plasma (PRP) in posterolateral arthrodesis. Methods Twenty consecutive patients underwent posterolateral arthrodesis with implantation of cancellous bone substitute soaked with PRP obtained directly in the operating theater on the right hemifield and cancellous bone substitute soaked with saline solution on the right. Results Computed tomography scans at 6 and 12 months after surgery were performed in all patients. Bone density was investigated by comparative analysis of region of interest. The data were analyzed with repeated-measures variance analyses with value of density after 6 months and value of density after 12 months, using age, levels of arthrodesis, and platelet count as covariates. The data demonstrated increased bone density using PRP and heterologous cancellous block resulting in an enhanced fusion rate during the first 6 months after surgery. Conclusions PRP used with cancellous bone substitute increases the rate of fusion and bone density joining osteoinductive and osteoconductive effect. PMID:25083353

  6. Efficacy of bone substitute material in preserving volume when placing a maxillary immediate complete denture: study protocol for the PANORAMIX randomized controlled trial.

    PubMed

    Rignon-Bret, Christophe; Hadida, Alain; Aidan, Alexis; Nguyen, Thien-Huong; Pasquet, Gerard; Fron-Chabouis, Helene; Wulfman, Claudine

    2016-05-20

    Bone preservation is an essential issue in the context of last teeth extraction and complete edentulism. The intended treatment, whether a complete denture or an implant placement, is facilitated with a voluminous residual ridge. Bone resorption after multiple extractions has not been as well studied as the bone resorption that occurs after the extraction of a single tooth. Recent advances in bone substitute materials have revived this issue. The purpose of this study is to evaluate the interest in using bone substitute material to fill the socket after last teeth extraction in a maxillary immediate complete denture procedure compared with the conventional protocol without socket filling. A randomized, controlled, clinical trial was designed. The 34 participants eligible for maxillary immediate complete denture were divided into two groups. Complete dentures were prepared despite persistence of the last anterior teeth. The control group received a conventional treatment including denture placement immediately after extractions. In the experimental group, in addition to the immediate denture placement, a xenograft bone-substitute material (Bio-Oss Collagen®) was placed in the fresh sockets. The primary outcome of the study is to compare mean bone ridge height loss 1 year after maxillary immediate complete denture placement, with or without bone-substitute material, in incisor and canine sockets. The secondary outcomes are to compare the average bone ridge height and width loss for each extraction site. An original quantitative evaluation method using cone beam computed tomography was designed for reproducible measurements, with a radio-opaque denture duplicate. Two independent operators perform the radiologic measurements. The immediate complete denture technique limits bone resorption in multiple extraction situations and thus allows better denture retention and better options for implant placement. To compare the benefit of using any bone socket-filling material

  7. DXAGE: A New Method for Age at Death Estimation Based on Femoral Bone Mineral Density and Artificial Neural Networks.

    PubMed

    Navega, David; Coelho, João d'Oliveira; Cunha, Eugénia; Curate, Francisco

    2017-08-29

    Age at death estimation in adult skeletons is hampered, among others, by the unremarkable correlation of bone estimators with chronological age, implementation of inappropriate statistical techniques, observer error, and skeletal incompleteness or destruction. Therefore, it is beneficial to consider alternative methods to assess age at death in adult skeletons. The decrease in bone mineral density with age was explored to generate a method to assess age at death in human remains. A connectionist computational approach, artificial neural networks, was employed to model femur densitometry data gathered in 100 female individuals from the Coimbra Identified Skeletal Collection. Bone mineral density declines consistently with age and the method performs appropriately, with mean absolute differences between known and predicted age ranging from 9.19 to 13.49 years. The proposed method-DXAGE-was implemented online to streamline age estimation. This preliminary study highlights the value of densitometry to assess age at death in human remains. © 2017 American Academy of Forensic Sciences.

  8. Lateral alveolar ridge augmentation using a synthetic nano-crystalline hydroxyapatite bone substitution material (Ostim): preliminary clinical and histological results.

    PubMed

    Strietzel, Frank Peter; Reichart, Peter A; Graf, Hans-Ludwig

    2007-12-01

    The purpose of this preliminary two-center clinical prospective study was to evaluate the tissue composition of augmented sites after the use of a nano-crystalline hydroxyapatite (ncHA) bone substitution material by clinical and histological examinations. A synthetic ncHA augmentation material was used without any additives in 14 patients requiring lateral ridge augmentation 6-7 months before (10 patients) or at implant placement (four patients). The ncHA material was covered by a titanium mesh for space maintenance. Clinical and radiographic parameters were evaluated and bone biopsy cores, obtained 6-7 months following augmentation, were assessed histologically and histomorphometrically. One patient showed gingival swelling, redness and pain at the augmentation site requiring removal of the titanium mesh 6 weeks postoperatively. In seven patients, a premature exposure of the titanium mesh without any inflammatory symptoms was noted. The width of the fixed gingival and the alveolar ridge height did not change significantly at least 6 months following augmentation (P>0.5), whereas a significant gain in alveolar ridge width (P=0.01) was noted. After a median period of prosthetic loading of 24 months, no implant was considered to be a failure. Histology revealed ncHA remnants in peripheral and central parts of biopsy cores obtained from seven patients after at least 6 months without histological symptoms of inflammation, whereas histomorphometry of bone cores revealed no significant differences of the mean percentage area of ncHA in peripheral (23.4%) and central (15.1%) parts of biopsy cores (P=0.262). The mean percentage area of bone colonizing the defect was 52.3%. Small amounts of ncHA were found after at least 6 months in bone biopsies. The former defect space was filled with bone. The alveolar ridge width gain was found to be significant after lateral augmentation utilizing ncHA, providing a quantitatively and qualitatively sufficient site for primary stable

  9. A novel bone substitute composite composed of tricalcium phosphate, gelatin and drynaria fortunei herbal extract.

    PubMed

    Dong, Guo-Chung; Chen, Hueih Min; Yao, Chun-Hsu

    2008-01-01

    The Chinese herb, Gu-Sui-Bu (GSB) (Drynaria fortunei J. Sm.) has been anecdotally reported to enhance bone healing. We had previously confirmed in vitro the efficacy and safety of GSB in bone healing, and showed that it influenced both osteoblast and osteoclast activity. For clinically useful application of these bone regenerative effects, a satisfactory delivery system for GSB is required. In this study, we determined the optimal concentration of GSB for regenerative activity in rat bone cells via MTT, alkaline phosphatase (ALP), nodule formation and TRAP assays, and designed and tested a GSB-rich bone composite material. The composite was fabricated by mixing a biodegradable GGT composite, containing genipin cross-linked gelatin and tricalcium phosphate, with the predetermined concentration of GSB (GGT-GSB). Neonatal rat calvarial culture and animal implantation were employed to evaluate and compare in vitro and in vivo the potential of GGT-GSB and GGT in regeneration of defective bone tissue. The most effective concentration of GSB was 100 mug/mL, which significantly increased osteoblast numbers, intracellular ALP levels and nodule numbers, without influencing osteoclast activity. In vitro and in vivo tests also showed that GGT-GSB accelerated bone regeneration compared to GGT. GGT-GSB thus has great potential for improved bone repair. (c) 2007 Wiley Periodicals, Inc. J Biomed Mater Res, 2008.

  10. Biodegradable polyurethane cancellous bone graft substitutes in the treatment of iliac crest defects.

    PubMed

    Gogolewski, Sylwester; Gorna, Katarzyna

    2007-01-01

    Porous scaffolds were produced from newly designed biodegradable, segmented aliphatic polyurethanes of various chemical compositions and hydrophilic-to-hydrophobic segment ratios. The scaffolds were implanted into monocortical defects in the iliac crest of healthy sheep for 6 months. The resected cortex was not repositioned. The ilium defects, which were not implanted with polyurethane scaffolds, were used as controls. In none of the control defects was there bone regeneration at the time of euthanasia. The defects implanted with porous scaffolds from polyurethanes were healed to varying extents with cancellous bone. The structure of the regenerated cancellous bone was radiographically denser than the structure of native bone. New bone that was formed in the scaffolds with a higher amount of hydrophilic component contained more calcium phosphate deposit than the bone formed in the scaffolds with a lower amount of the hydrophilic component. There was no new cortex formed over the defect, but a thin layer of soft tissue covered the newly formed cancellous bone. (c) 2006 Wiley Periodicals, Inc.

  11. Biologically inspired rosette nanotubes and nanocrystalline hydroxyapatite hydrogel nanocomposites as improved bone substitutes.

    PubMed

    Zhang, Lijie; Rodriguez, Jose; Raez, Jose; Myles, Andrew J; Fenniri, Hicham; Webster, Thomas J

    2009-04-29

    Today, bone diseases such as bone fractures, osteoporosis and bone cancer represent a common and significant public health problem. The design of biomimetic bone tissue engineering materials that could restore and improve damaged bone tissues provides exciting opportunities to solve the numerous problems associated with traditional orthopedic implants. Therefore, the objective of this in vitro study was to create a biomimetic orthopedic hydrogel nanocomposite based on the self-assembly properties of helical rosette nanotubes (HRNs), the osteoconductive properties of nanocrystalline hydroxyapatite (HA), and the biocompatible properties of hydrogels (specifically, poly(2-hydroxyethyl methacrylate), pHEMA). HRNs are self-assembled nanomaterials that are formed from synthetic DNA base analogs in water to mimic the helical nanostructure of collagen in bone. In this study, different geometries of nanocrystalline HA were controlled by either hydrothermal or sintering methods. 2 and 10 wt% nanocrystalline HA particles were well dispersed into HRN hydrogels using ultrasonication. The nanocrystalline HA and nanocrystalline HA/HRN hydrogels were characterized by x-ray diffraction, transmission electron microscopy, and scanning electron microscopy. Mechanical testing studies revealed that the well dispersed nanocrystalline HA in HRN hydrogels possessed improved mechanical properties compared to hydrogel controls. In addition, the results of this study provided the first evidence that the combination of either 2 or 10 wt% nanocrystalline HA and 0.01 mg ml(-1) HRNs in hydrogels greatly increased osteoblast (bone-forming cell) adhesion up to 236% compared to hydrogel controls. Moreover, this study showed that HRNs stimulated HA nucleation and mineralization along their main axis in a way that is very reminiscent of the HA/collagen assembly pattern in natural bone. In summary, the presently observed excellent properties of the biomimetic nanocrystalline HA/HRN hydrogel composites

  12. Histologic and histomorphometric results of three bone graft substitutes after sinus augmentation in humans.

    PubMed

    Pettinicchio, Marzia; Traini, Tonino; Murmura, Giovanna; Caputi, Sergio; Degidi, Marco; Mangano, Carlo; Piattelli, Adriano

    2012-02-01

    The aim of this study was to compare the histological behavior of three bone graft materials placed in human. The comparison was made among Bio-Oss® (BO), Engipore® (EP), and PepGen P-15® (P-15). Five biopsies for each group of biomaterial, retrieved 6 months after sinus lift augmentation, were analyzed. The investigation was carried out using light microscope (LM), scanning electron microscope (SEM) with an energy dispersive spectrometer (EDS), and circularly polarized light microscope (CPLM). Under LM, the amount of newly formed bone was significantly higher in BO than P-15 (P < .05), while the amount of residual graft material was significantly higher in P-15 than BO (P < .05). The extension of marrow spaces was significantly higher in EP than both BO and P-15 (P < .05). SEM-EDS analysis showed a Ca/P ratio of 1.8 for BO, 2.2 for EP, and 1.5 for P-15. Under CPLM, BO showed no significant difference for transverse (18.4 ± 2.7%) and longitudinal (16.3 ± 1.8%) bone collagen fibers (P = .195); EP showed a significant difference between transverse (4 ± 0.7%) and longitudinal (7.6 ± 2.5%) bone collagen fibers (P = .015); finally, P-15 showed no significant difference for transverse (3.8 ± 1.6%) and longitudinal (4.9 ± 1.2%) bone collagen fibers (P = .279). No investigated biomaterial was completely resorbed, but all the residual particles demonstrated a close bone integration to form a hybrid tissue. BO particles appeared perfectly osseointegrated in the trabecular bone. EP showed a tendency to concentrate the bone apposition into the microporosities; P-15 particles appeared bridged by newly formed bone trabeculae.

  13. Biologically inspired rosette nanotubes and nanocrystalline hydroxyapatite hydrogel nanocomposites as improved bone substitutes

    NASA Astrophysics Data System (ADS)

    Zhang, Lijie; Rodriguez, Jose; Raez, Jose; Myles, Andrew J.; Fenniri, Hicham; Webster, Thomas J.

    2009-04-01

    Today, bone diseases such as bone fractures, osteoporosis and bone cancer represent a common and significant public health problem. The design of biomimetic bone tissue engineering materials that could restore and improve damaged bone tissues provides exciting opportunities to solve the numerous problems associated with traditional orthopedic implants. Therefore, the objective of this in vitro study was to create a biomimetic orthopedic hydrogel nanocomposite based on the self-assembly properties of helical rosette nanotubes (HRNs), the osteoconductive properties of nanocrystalline hydroxyapatite (HA), and the biocompatible properties of hydrogels (specifically, poly(2-hydroxyethyl methacrylate), pHEMA). HRNs are self-assembled nanomaterials that are formed from synthetic DNA base analogs in water to mimic the helical nanostructure of collagen in bone. In this study, different geometries of nanocrystalline HA were controlled by either hydrothermal or sintering methods. 2 and 10 wt% nanocrystalline HA particles were well dispersed into HRN hydrogels using ultrasonication. The nanocrystalline HA and nanocrystalline HA/HRN hydrogels were characterized by x-ray diffraction, transmission electron microscopy, and scanning electron microscopy. Mechanical testing studies revealed that the well dispersed nanocrystalline HA in HRN hydrogels possessed improved mechanical properties compared to hydrogel controls. In addition, the results of this study provided the first evidence that the combination of either 2 or 10 wt% nanocrystalline HA and 0.01 mg ml-1 HRNs in hydrogels greatly increased osteoblast (bone-forming cell) adhesion up to 236% compared to hydrogel controls. Moreover, this study showed that HRNs stimulated HA nucleation and mineralization along their main axis in a way that is very reminiscent of the HA/collagen assembly pattern in natural bone. In summary, the presently observed excellent properties of the biomimetic nanocrystalline HA/HRN hydrogel composites

  14. Use of the volar fixed angle plate for comminuted distal radius fractures and augmentation with a hydroxyapatite bone graft substitute.

    PubMed

    Goto, Akira; Murase, Tsuyoshi; Oka, Kunihiro; Yoshikawa, Hideki

    2011-01-01

    Treatment of distal radius fractures with a volar fixed angle plate achieves sufficient stabilisation and permits early physical exercise. However, secondary displacement after surgery sometimes occurs in elderly patients with a metaphyseal comminution and/or cases in which the subchondral support pegs were not placed immediately below the subchondral zone. We treated elderly patients suffering from distal radius fractures with metaphyseal comminution, using both volar fixed angle plate with or without augmentation with a hydroxyapatite bone graft substitute to investigate the benefit of augmentation for maintaining a fracture reduction. We evaluated the differences among radiographic parameters including palmar tilt, radial inclination, and ulnar variance on immediate postoperative and final follow-up radiographs to analyse the maintenance of the initial reduction. There were no significant differences between the two groups in terms of palmar tilt (P = 0.80) and radial inclination (P = 0.17); however, ulnar variance increased significantly in the group treated with a volar fixed angle plate without augmentation (P < 0.05). It might be useful to use a combination technique of a locking plate system and the hydroxyapatite bone graft substitute as augmentation to treat distal radius comminuted fractures in elderly patients.

  15. Subject-specific bone attenuation correction for brain PET/MR: can ZTE-MRI substitute CT scan accurately?

    PubMed

    Khalifé, Maya; Fernandez, Brice; Jaubert, Olivier; Soussan, Michael; Brulon, Vincent; Buvat, Irene; Comtat, Claude

    2017-08-24

    In brain PET/MR applications, accurate attenuation maps are required for accurate PET image quantification. An implemented attenuation correction (AC) method for brain imaging is the single-atlas approach which estimates an AC map from an averaged CT template. As an alternative, we propose to use a Zero Echo Time (ZTE) pulse sequence to segment bone, air and soft tissue. A linear relationship between histogram normalized ZTE intensity and measured CT density in Hounsfield Units (HU) in bone has been established thanks to a CT-MR database of 16 patients. Continuous AC maps were computed based on the segmented ZTE by setting a fixed linear attenuation coefficient (LAC) for air and soft tissue and by using the linear relationship to generate a continuous LAC map for the bone. Additionally, for comparison purpose, four other AC maps were generated: a ZTE derived AC map with a fixed LAC for the bone, an AC map based on the single-atlas approach as provided by the PET/MR manufacturer, a soft-tissue only AC map where the bone is ignored and, finally, the CT derived attenuation map used as the gold standard (CTAC). All these AC maps were used with different levels of smoothing for PET image reconstruction with and without time-of-flight (TOF). The subject-specific AC map gen- erated by combining ZTE-based segmentation and linear scaling of the normalized ZTE signal into HU was found to be a good substitute for the measured CTAC map in brain PET/MR when used with a Gaussian smoothing kernel of 4 mm corresponding to the PET scanner intrinsic resolution. As expected TOF reduces AC error regardless of the AC method. The continuous ZTE-AC performed better than the other alternative MR derived AC methods, reducing the quantification error between the MRAC corrected PET image and the reference CTAC corrected PET image. © 2017 Institute of Physics and Engineering in Medicine.

  16. In vitro degradation and cell response of calcium carbonate composite ceramic in comparison with other synthetic bone substitute materials.

    PubMed

    He, Fupo; Zhang, Jing; Yang, Fanwen; Zhu, Jixiang; Tian, Xiumei; Chen, Xiaoming

    2015-05-01

    The robust calcium carbonate composite ceramics (CC/PG) can be acquired by fast sintering calcium carbonate at a low temperature (650 °C) using a biocompatible, degradable phosphate-based glass (PG) as sintering agent. In the present study, the in vitro degradation and cell response of CC/PG were assessed and compared with 4 synthetic bone substitute materials, calcium carbonate ceramic (CC), PG, hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) ceramics. The degradation rates in decreasing order were as follows: PG, CC, CC/PG, β-TCP, and HA. The proliferation of rat bone mesenchymal stem cells (rMSCs) cultured on the CC/PG was comparable with that on CC and PG, but inferior to HA and β-TCP. The alkaline phosphatase (ALP) activity of rMSCs on CC/PG was lower than PG, comparable with β-TCP, but higher than HA. The rMSCs on CC/PG and PG had enhanced gene expression in specific osteogenic markers, respectively. Compared to HA and β-TCP, the rMSCs on the CC/PG expressed relatively lower level of collagen I and runt-related transcription factor 2, but showed more considerable expression of osteopontin. Although CC, PG, HA, and β-TCP possessed impressive performances in some specific aspects, they faced extant intrinsic drawbacks in either degradation rate or mechanical strength. Based on considerable compressive strength, moderate degradation rate, good cell response, and being free of obvious shortcoming, the CC/PG is promising as another choice for bone substitute materials. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Novel bone substitute composed of chitosan and strontium-doped α-calcium sulfate hemihydrate: Fabrication, characterisation and evaluation of biocompatibility.

    PubMed

    Chen, Yirong; Zhou, Yilin; Yang, Shenyu; Li, Jiao Jiao; Li, Xue; Ma, Yunfei; Hou, Yilong; Jiang, Nan; Xu, Changpeng; Zhang, Sheng; Zeng, Rong; Tu, Mei; Yu, Bin

    2016-09-01

    Calcium sulfate is in routine clinical use as a bone substitute, offering the benefits of biodegradability, biocompatibility and a long history of use in bone repair. The osteoconductive properties of calcium sulfate may be further improved by doping with strontium ions. Nevertheless, the high degradation rate of calcium sulfate may impede bone healing as substantial material degradation may occur before the healing process is complete. The purpose of this study is to develop a novel composite bone substitute composed of chitosan and strontium-doped α-calcium sulfate hemihydrate in the form of microcapsules, which can promote osteogenesis while matching the natural rate of bone healing. The developed microcapsules exhibited controlled degradation that facilitated the sustained release of strontium ions. In vitro testing showed that the microcapsules had minimal cytotoxicity and ability to inhibit bacterial growth. In vivo testing in a mouse model showed the absence of genetic toxicity and low inflammatory potential of the microcapsules. The novel microcapsules developed in this study demonstrated suitable degradation characteristics for bone repair as well as favourable in vitro and in vivo behaviour, and hold promise for use as an alternative bone substitute in orthopaedic surgery. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Volumetric analysis of bone substitute material performance within the human sinus cavity of former head and neck cancer patients: A prospective, randomized clinical trial

    PubMed Central

    Lorenz, Jonas; Eichler, Kathrin; Barbeck, Mike; Lerner, Henriette; Stübinger, Stefan; Seipel, Catherine; Vogl, Thomas J.; Kovács, Adorján F.; Ghanaati, Shahram; Sader, Robert A.

    2016-01-01

    Background: In numerous animal and human studies, it could be detected that in bone augmentation procedures, material's physicochemical characteristics can influence the cellular inflammatory pattern and therefore the integration in the host tissue. Histological, histomorphometrical, and clinical analyses of the integration of the biomaterial in the surrounding tissue are well established methodologies; however, they do not make a statement on volume and density changes of the augmented biomaterial. Aims: The aim of the present study was to assess the volume and density of a xenogeneic (Bio-Oss®, BO) and a synthetic (NanoBone®, NB) bone substitute material in split-mouth sinus augmentations in former tumor patients to complete histological and histomorphometrical assessment. Methods: Immediately and 6 months after sinus augmentation computed tomography scans were recorded, bone grafts were marked, and the volume was calculated with radiologic RIS-PACS software (General Electric Healthcare, Chalfont St. Giles, Great Britain) to determine the integration and degradation behavior of both biomaterials. Results: Radiographic analysis revealed a volume reduction of the initial augmented bone substitute material (i.e. 100%) to 77.36 (±11.68) % in the BO-group, respectively, 75.82 (±22.28) % in the NB-group six months after augmentation. In both materials, the volume reduction was not significant. Bone density significantly increased in both groups. Conclusion: The presented radiological investigation presents a favorable method to obtain clinically relevant information concerning the integration and degradation behavior of bone substitute materials. PMID:28299254

  19. Quantifying migration and polarization of murine mesenchymal stem cells on different bone substitutes by confocal laser scanning microscopy.

    PubMed

    Roldán, J C; Chang, E; Kelantan, M; Jazayeri, L; Deisinger, U; Detsch, R; Reichert, T E; Gurtner, G C

    2010-12-01

    Cell migration is preceded by cell polarization. The aim of the present study was to evaluate the impact of the geometry of different bone substitutes on cell morphology and chemical responses in vitro. Cell polarization and migration were monitored temporally by using confocal laser scanning microscopy (CLSM) to follow green fluorescent protein (GFP)±mesenchymal stem cells (MSCs) on anorganic cancellous bovine bone (Bio-Oss(®)), β-tricalcium phosphate (β-TCP) (chronOS(®)) and highly porous calcium phosphate ceramics (Friedrich-Baur-Research-Institute for Biomaterials, Germany). Differentiation GFP±MSCs was observed using pro-angiogenic and pro-osteogenic biomarkers. At the third day of culture polarized vs. non-polarized cellular sub-populations were clearly established. Biomaterials that showed more than 40% of polarized cells at the 3rd day of culture, subsequently showed an enhanced cell migration compared to biomaterials, where non-polarized cells predominated (p<0.003). This trend continued untill the 7th day of culture (p<0.003). The expression of vascular endothelial growth factor was enhanced in biomaterials where cell polarization predominated at the 7th day of culture (p=0.001). This model opens an interesting approach to understand osteoconductivity at a cellular level. MSCs are promising in bone tissue engineering considering the strong angiogenic effect before differentiation occurs. Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  20. Implantation of tetrapod-shaped granular artificial bones or β-tricalcium phosphate granules in a canine large bone-defect model.

    PubMed

    Choi, Sungjin; Liu, I-Li; Yamamoto, Kenichi; Honnami, Muneki; Sakai, Takamasa; Ohba, Shinsuke; Echigo, Ryosuke; Suzuki, Shigeki; Nishimura, Ryouhei; Chung, Ung-Il; Sasaki, Nobuo; Mochizuki, Manabu

    2014-03-01

    We investigated biodegradability and new bone formation after implantation of tetrapod-shaped granular artificial bone (Tetrabone®) or β-tricalcium phosphate granules (β-TCP) in experimental critical-size defects in dogs, which were created through medial and lateral femoral condyles. The defect was packed with Tetrabone® (Tetrabone group) or β-TCP (β-TCP group) or received no implant (control group). Computed tomography (CT) was performed at 0, 4 and 8 weeks after implantation. Micro-CT and histological analysis were conducted to measure the non-osseous tissue rate and the area and distribution of new bone tissue in the defect at 8 weeks after implantation. On CT, β-TCP was gradually resorbed, while Tetrabone® showed minimal resorption at 8 weeks after implantation. On micro-CT, non-osseous tissue rate of the control group was significantly higher compared with the β-TCP and Tetrabone groups (P<0.01), and that of the β-TCP group was significantly higher compared with the Tetrabone group (P<0.05). On histology, area of new bone tissue of the β-TCP group was significantly greater than those of the Tetrabone and control groups (P<0.05), and new bone distribution of the Tetrabone group was significantly greater than those of the β-TCP and control groups (P<0.05). These results indicate differences in biodegradability and connectivity of intergranule pore structure between study samples. In conclusion, Tetrabone® may be superior for the repair of large bone defects in dogs.

  1. Effects of screw eccentricity on the initial stability of the acetabular cup in artificial foam bone of different qualities.

    PubMed

    Hsu, Jui-Ting; Lin, Dan-Jae

    2010-01-01

    Acetabular cup loosening is one of the major failure models of total hip replacement (THR), which is mostly due to insufficient initial stability of the cup. Previous studies have demonstrated that cup stability is affected by the quality of the host bone and the surgical skill when inserting screws. The purpose of this study was to determine the effects on the initial stability of the acetabular cup of eccentric screws in bone of different qualities. In this study, hemispherical cups were fixed into bone specimens constructed from artificial foam with three elastic moduli using one to three screws. The effects of two types of screw eccentricity (offset and angular) on the stability of the acetabular cup were also evaluated. The experimental results indicate that in the presence of ideal screwing, the cup was stable in bone specimens constructed from foam with the highest elastic modulus. In addition, increasing the number of ideal screws enhanced the cup stability, especially in bone specimens constructed from soft foam. Moreover, the cup stability was most affected by offset eccentric screw(s) in the hard-foam bone specimens and by angular eccentric screw(s) in the soft-foam bone specimens. The reported results indicate that the presence of screw eccentricity affects the initial stability of the acetabular cup. Surgeons should keep this in mind when performing screw insertions in THR. However, care is necessary when translating these results to the intraoperative situation due to the experiments being conducted under laboratory conditions, and hence, future studies should attempt to replicate the results reported here in vivo.

  2. Artificial blood.

    PubMed

    Sarkar, Suman

    2008-07-01

    Artificial blood is a product made to act as a substitute for red blood cells. While true blood serves many different functions, artificial blood is designed for the sole purpose of transporting oxygen and carbon dioxide throughout the body. Depending on the type of artificial blood, it can be produced in different ways using synthetic production, chemical isolation, or recombinant biochemical technology. Development of the first blood substitutes dates back to the early 1600s, and the search for the ideal blood substitute continues. Various manufacturers have products in clinical trials; however, no truly safe and effective artificial blood product is currently marketed. It is anticipated that when an artificial blood product is available, it will have annual sales of over $7.6 billion in the United States alone.

  3. Transmigration of fibrino-purulent inflammation and malignant cells into an artificial dura substitute (Neuro-Patch): report of two cases.

    PubMed

    El Majdoub, Faycal; Löhr, Mario; Maarouf, Mohammad; Brunn, Anna; Stenzel, Werner; Ernestus, Ralf-Ingo

    2009-07-01

    The objective of this work was to present possible, though rare, complications of Neuro-Patch implantation after brain surgery. Two patients, aged 62 and 63 years, who had a partial dural substitution with an artificial polyurethane graft after neurosurgical resection of a gross tumour, are presented. In the two patients, the a-vital tissue was infiltrated by either inflammatory or neoplastic tissue respectively. This report demonstrates a new pathological point of view in using synthetic materials for the reconstruction of dural defects.

  4. [Expansive pedicle screws fixation combined with Wright artificial bone implantation for treatment of thoracolumbar burst fracture of the elderly patients].

    PubMed

    Sun, Bin-feng; Dong, Yi; Lü, Jian-yuan; Gu, Xiao-juan

    2011-07-01

    To observe the effects of expansive pedicle screws fixation combined Wright artificial bone implantation in treating thoracolumbar burst fracture of the elderly. From March 2007 to July 2009, 12 patients with thoracolumbar burst fractures were treated with surgery in the study. There were 7 males and 5 females, with an average age of 62.3 years (from 56 to 71 years). Nerve functions of all patients were ASIA classified grade E. According to TLICS score system, 6 points were in 5 cases and 7 points were in 7 cases. Expansive pedicle screw system was used and Wright artificial bone was injected into the injuried vertebrae. The anterior border height of vertebral body and Cobb angle were observed at the preoperation, postoperation and final follow-up. All patients were followed up from 10 to 15 months with an average of 12 months. Wounds healed well, pain in the chest-back abated, no the expansive pedicle screws loosened or broke down. The anterior border height of vertebral body increased from (32.3 +/- 9.1)% preoperatively to (95.3 +/- 3.2)% postoperatively; and the Cobb angle decreased from (31.6 +/- 6.8) degrees preoperatively to (4.5 +/- 3.2) degrees postoperatively. There was significant difference between two groups (P<0.01). After 3 months, the anterior border height of vertebral body was (94.7 +/- 3.3)% and the Cobb angle was (4.6 +/- 3.4) degrees; at the final follow-up, the anterior border height of vertebral body was (93.2 +/- 3.6)% and the Cobb angle was (5.3 +/- 3.7) degrees. There was no significant difference between the two data (P>0.05). The combination of expansive pedicle screws fixation and Wright artificial bone injection is a good treatment for thoracolumbar burst fracture, with advantages such as easy operation and good effect, which mainly applied to patients with no obvious nerve injuries.

  5. Extraction site preservation using an in-situ hardening alloplastic bone graft substitute.

    PubMed

    Leventis, Minas D; Fairbairn, Peter; Horowitz, Robert A

    2014-01-01

    This case report highlights the use of an in-situ hardening alloplastic bone grafting material composed of beta-tricalcium phosphate (β-TCP) granules coated with poly(lactic-co-glycolic acid) (PLGA) to preserve the dimensions and architecture of the alveolar ridge after atraumatic extraction. This material provided a stable scaffold that, although left uncovered, deterred the ingrowth of unwanted soft tissue, allowing newly formed keratinized soft tissue to proliferate over the healing grafted socket and gradually cover the site. At re-entry after 4 months adequate newly formed bone was observed, allowing for the correct positional placement of an implant. The results of this case suggest that an in-situ hardening alloplastic grafting material can be successfully utilized with minimally invasive procedures to preserve the bone and the soft-tissue profile of the alveolar ridge for future implant rehabilitation.

  6. In vitro evaluation of samarium (III) oxide as a bone substituting material.

    PubMed

    Herath, H M T U; Di Silvio, L; Evans, J R G

    2010-07-01

    The biocompatibility of natural samarium (III) oxide, which has previously been used for treatment in bone-related diseases was determined as a first step in its evaluation as a bone implant material. Assessment for 28 days using osteoblast-like cells revealed no indications of cytotoxicity. The cells adhered and proliferated on the surface. Furthermore, the differentiation and mineralization were observed, indicating a normal biological response of the cells on the samarium (III) oxide surface. The in vitro, short term biocompatibility assessment of this oxide has indicated its biosafety with no damaging toxic effects on the cells and biofunctionality; with an appropriate cell response for a bone-contacting material. Hence, samarium (III) oxide deserves recognition in the field of biomaterials for its excellent in vitro performance and demonstrates that the class of potential bioceramics may be larger than previously thought. (c) 2010 Wiley Periodicals, Inc. J Biomed Mater Res, 2010.

  7. Human Perivascular Stem Cell-Based Bone Graft Substitute Induces Rat Spinal Fusion

    PubMed Central

    Chung, Choon G.; James, Aaron W.; Asatrian, Greg; Chang, Le; Nguyen, Alan; Le, Khoi; Bayani, Georgina; Lee, Robert; Stoker, David; Zhang, Xinli

    2014-01-01

    Adipose tissue is an attractive source of mesenchymal stem cells (MSCs) because of its abundance and accessibility. We have previously defined a population of native MSCs termed perivascular stem cells (PSCs), purified from diverse human tissues, including adipose tissue. Human PSCs (hPSCs) are a bipartite cell population composed of pericytes (CD146+CD34−CD45−) and adventitial cells (CD146−CD34+CD45−), isolated by fluorescence-activated cell sorting and with properties identical to those of culture identified MSCs. Our previous studies showed that hPSCs exhibit improved bone formation compared with a sample-matched unpurified population (termed stromal vascular fraction); however, it is not known whether hPSCs would be efficacious in a spinal fusion model. To investigate, we evaluated the osteogenic potential of freshly sorted hPSCs without culture expansion and differentiation in a rat model of posterolateral lumbar spinal fusion. We compared increasing dosages of implanted hPSCs to assess for dose-dependent efficacy. All hPSC treatment groups induced successful spinal fusion, assessed by manual palpation and microcomputed tomography. Computerized biomechanical simulation (finite element analysis) further demonstrated bone fusion with hPSC treatment. Histological analyses showed robust endochondral ossification in hPSC-treated samples. Finally, we confirmed that implanted hPSCs indeed differentiated into osteoblasts and osteocytes; however, the majority of the new bone formation was of host origin. These results suggest that implanted hPSCs positively regulate bone formation via direct and paracrine mechanisms. In summary, hPSCs are a readily available MSC population that effectively forms bone without requirements for culture or predifferentiation. Thus, hPSC-based products show promise for future efforts in clinical bone regeneration and repair. PMID:25154782

  8. Human perivascular stem cell-based bone graft substitute induces rat spinal fusion.

    PubMed

    Chung, Choon G; James, Aaron W; Asatrian, Greg; Chang, Le; Nguyen, Alan; Le, Khoi; Bayani, Georgina; Lee, Robert; Stoker, David; Zhang, Xinli; Ting, Kang; Péault, Bruno; Soo, Chia

    2014-10-01

    Adipose tissue is an attractive source of mesenchymal stem cells (MSCs) because of its abundance and accessibility. We have previously defined a population of native MSCs termed perivascular stem cells (PSCs), purified from diverse human tissues, including adipose tissue. Human PSCs (hPSCs) are a bipartite cell population composed of pericytes (CD146+CD34-CD45-) and adventitial cells (CD146-CD34+CD45-), isolated by fluorescence-activated cell sorting and with properties identical to those of culture identified MSCs. Our previous studies showed that hPSCs exhibit improved bone formation compared with a sample-matched unpurified population (termed stromal vascular fraction); however, it is not known whether hPSCs would be efficacious in a spinal fusion model. To investigate, we evaluated the osteogenic potential of freshly sorted hPSCs without culture expansion and differentiation in a rat model of posterolateral lumbar spinal fusion. We compared increasing dosages of implanted hPSCs to assess for dose-dependent efficacy. All hPSC treatment groups induced successful spinal fusion, assessed by manual palpation and microcomputed tomography. Computerized biomechanical simulation (finite element analysis) further demonstrated bone fusion with hPSC treatment. Histological analyses showed robust endochondral ossification in hPSC-treated samples. Finally, we confirmed that implanted hPSCs indeed differentiated into osteoblasts and osteocytes; however, the majority of the new bone formation was of host origin. These results suggest that implanted hPSCs positively regulate bone formation via direct and paracrine mechanisms. In summary, hPSCs are a readily available MSC population that effectively forms bone without requirements for culture or predifferentiation. Thus, hPSC-based products show promise for future efforts in clinical bone regeneration and repair. ©AlphaMed Press.

  9. Analyses of mineral specific surface area and hydroxyl substitution for intact bone.

    PubMed

    Taylor, Amanda J; Rendina, Elizabeth; Smith, Brenda J; Zhou, Donghua H

    2013-11-19

    Bone minerals possess two primary hydrogen sources: hydroxide ions in the nanocrystalline core and structural water in the amorphous surface layer. In order to accurately measure their concentrations using hydrogen to phosphorus cross polarization NMR spectroscopy, it is necessary to analyze the dependence of signal intensities on serial contact times, namely, cross polarization kinetics. A reliable protocol is developed to iteratively decompose the severely overlapped spectra and to analyze the cross-polarization kinetics, leading to measurement of hydroxyl and structural water concentrations. Structural water concentration is used to estimate mineral specific surface area and nanocrystal thickness for intact bone.

  10. A new bioinspired collagen-hydroxyapatite bone graft substitute in adult scoliosis surgery: results at 3-year follow-up.

    PubMed

    Giorgi, Pietro; Capitani, Dario; Sprio, Simone; Sandri, Monica; Tampieri, Anna; Canella, Valentina; Nataloni, Angelo; Schirò, Giuseppe R

    2017-07-27

    Spinal fusion is a common procedure used for surgical treatment of spinal deformity. In recent years, many bone graft substitutes (BGS) have been developed to provide good arthrodesis when the available autologous bone harvested from the patient is not enough. The aim of this study was to analyze the use of a new-generation composite material (RegenOss) made of Mg-hydroxyapatite nanoparticles nucleated on type I collagen to obtain long posterolateral fusion in adult scoliosis surgery. A total of 41 patients who underwent spinal fusion for the treatment of adult scoliosis were retrospectively analyzed. According to Lenke classification, visual analog scale (VAS) score and Oswestry Disability Index (ODI) score, radiographic rates of bone union were evaluated before surgery and at 6, 12 and 36 months of follow-up. Fusion was considered to be successful when criteria for Lenke grade A or B were satisfied. Patient-related risk factors were considered for the evaluation of the final outcome. At 36-month follow-up, radiographic evidence of spinal fusion was present in the majority of patients (95.1%). A time-dependent statistically significant improvement was evidenced after surgery for all clinical outcomes evaluated. Based on the demographic data collected, there were no statistically significant factors determining fusion. The correction of deformity was maintained at different time points. No intraoperative or postoperative complications were recorded. The present study demonstrated that RegenOss can safely be used to achieve good arthrodesis when associated with autologous bone graft to obtain long spinal fusion in the treatment of adult scoliosis.

  11. Subject-specific bone attenuation correction for brain PET/MR: can ZTE-MRI substitute CT scan accurately?

    NASA Astrophysics Data System (ADS)

    Khalifé, Maya; Fernandez, Brice; Jaubert, Olivier; Soussan, Michael; Brulon, Vincent; Buvat, Irène; Comtat, Claude

    2017-10-01

    In brain PET/MR applications, accurate attenuation maps are required for accurate PET image quantification. An implemented attenuation correction (AC) method for brain imaging is the single-atlas approach that estimates an AC map from an averaged CT template. As an alternative, we propose to use a zero echo time (ZTE) pulse sequence to segment bone, air and soft tissue. A linear relationship between histogram normalized ZTE intensity and measured CT density in Hounsfield units (HU ) in bone has been established thanks to a CT-MR database of 16 patients. Continuous AC maps were computed based on the segmented ZTE by setting a fixed linear attenuation coefficient (LAC) to air and soft tissue and by using the linear relationship to generate continuous μ values for the bone. Additionally, for the purpose of comparison, four other AC maps were generated: a ZTE derived AC map with a fixed LAC for the bone, an AC map based on the single-atlas approach as provided by the PET/MR manufacturer, a soft-tissue only AC map and, finally, the CT derived attenuation map used as the gold standard (CTAC). All these AC maps were used with different levels of smoothing for PET image reconstruction with and without time-of-flight (TOF). The subject-specific AC map generated by combining ZTE-based segmentation and linear scaling of the normalized ZTE signal into HU was found to be a good substitute for the measured CTAC map in brain PET/MR when used with a Gaussian smoothing kernel of 4~mm corresponding to the PET scanner intrinsic resolution. As expected TOF reduces AC error regardless of the AC method. The continuous ZTE-AC performed better than the other alternative MR derived AC methods, reducing the quantification error between the MRAC corrected PET image and the reference CTAC corrected PET image.

  12. A platelet-rich plasma-based membrane as a periosteal substitute with enhanced osteogenic and angiogenic properties: a new concept for bone repair.

    PubMed

    El Backly, Rania M; Zaky, Samer H; Muraglia, Anita; Tonachini, Laura; Brun, Francesco; Canciani, Barbara; Chiapale, Danilo; Santolini, Federico; Cancedda, Ranieri; Mastrogiacomo, Maddalena

    2013-01-01

    The periosteum plays a pivotal role during bone development and repair contributing to bone vascularization and osteoprogenitor cells source. We propose a periosteal substitute engineered using a platelet-rich plasma (PRP) membrane incorporating autologous bone marrow-derived mesenchymal stem cells (PRP/BMSC gel membrane) to be wrapped around an osteoconductive scaffold for regeneration of compromised bone defects. The PRP/BMSC gel membrane was optimized using different compositions for optimal release of vascular endothelial growth factor (VEGF) and platelet derived growth factor-BB (PDGF-BB). Survival and proliferation of cells in the PRP gel membrane with time were confirmed in addition to their osteogenic capacity. Furthermore, to evaluate the possible effects of the PRP/BMSC gel membrane on surrounding progenitor cells in the injury area, we found that the PRP gel membrane products could significantly induce the migration of human endothelial cells in vitro, and increased the expression of bone morphogenetic protein 2 in cultured BMSC. These cells also secreted significant amounts of soluble proangiogenic factors, such as PDGF-BB, VEGF, and interleukin-8 (IL-8). Finally, the functionality of the PRP/BMSC gel membrane periosteal substitute for bone regeneration was tested in vivo both in an ectopic mouse model as well as in a rabbit segmental bone defect model providing evidence of its capacity to biomimic a periosteal response enhancing bone regeneration.

  13. In vitro assessment of Function Graded (FG) artificial Hip joint stem in terms of bone/cement stresses: 3D Finite Element (FE) study.

    PubMed

    Al-Jassir, Fawzi F; Fouad, H; Alothman, Othaman Y

    2013-01-16

    Stress shielding in the cemented hip prosthesis occurs due to the mismatching in the mechanical properties of metallic stem and bone. This mismatching in properties is considered as one of the main reasons for implant loosening. Therefore, a new stem material in orthopedic surgery is still required. In the present study, 3D finite element modeling is used for evaluating the artificial hip joint stem that is made of Function Graded (FG) material in terms of joint stress distributions and stem length. 3D finite element models of different stems made of two types of FG materials and traditional stems made of Cobalt Chromium alloy (CoCrMo) and Titanium alloy (Ti) were developed using the ANSYS Code. The effects on the total artificial hip joint stresses (Shear stress and Von Mises stresses at bone cement, Von Mises stresses at bone and stem) due to using the proposed FG materials stems were investigated. The effects on the total artificial hip joint system stresses due to using different stem lengths were investigated. Using FG stem (with low stiffness at stem distal end and high stiffness at its proximal end) resulted in a significant reduction in shear stress at the bone cement/stem interface. Also, the Von Mises stresses at the bone cement and stem decrease significantly when using FG material instead of CoCrMo and Ti alloy. The stresses' distribution along the bone cement length when using FG material was found to be more uniform along the whole bone cement compared with other stem materials. These more uniform stresses will help in the reduction of the artificial hip joint loosening rate and improve its short and long term performance. FE results showed that using FG stem increases the resultant stresses at the femur bone (reduces stress shielding) compared to metallic stem. The results showed that the stem length has significant effects on the resultant shear and Von Mises stresses at bone, stem and bone cement for all types of stem materials.

  14. Superplastic deformation in carbonate apatite ceramics under constant compressive loading for near-net-shape production of bioresorbable bone substitutes.

    PubMed

    Adachi, Masanori; Wakamatsu, Nobukazu; Doi, Yutaka

    2008-01-01

    To produce carbonate apatite (CAP) ceramics with the desired complex shapes using superplastic deformation, deformation behavior of CAP ceramics under constant loading as well as physical properties after deformation were evaluated. Sintered CAP ceramics were plastically deformed in an electric furnace attached to a universal hydraulic testing machine under a constant load. CAP ceramics subjected to an initial compressive pressure of 10 MPa showed an appreciable amount of plastic deformation at temperatures ranging from 720 to 800 degrees C. Plastic deformation increased with increasing temperature from about 10% to 70% after two hours of loading. X-ray diffraction analysis and SEM observation further revealed that some CAP crystals were elongated and aligned with the c-axis normal to the loading direction during superplastic deformation. It was thus concluded that a marked plastic deformation of about 70% at 800 degrees C would be sufficient for near-net-shape production of bioresorbable CAP bone substitutes with complex shapes.

  15. [Comparative analysis and clinical experience with osteoplastic materials materials based on non-demineralized bone collagen and artificial hydroxylapatite at the close of bone defects in ambulatory surgical dentistry].

    PubMed

    Dunaev, M V; Kitaev, V A; Matavkina, M V; Druzhinin, A E; Bubnov, A S

    2014-01-01

    In the presence of bone defects during surgery is not always performed osteoptastic material replenishment defect that leads to a lengthening of the timing healing, bone regeneration, and treatment outcome. Application of osteoplastic materials allows for faster treatment outcomes, accelerate the regeneration of bone tissue in the area of the defect. To examine the effectiveness of materials based on non-demineralized bone collagen and artificial hydroxylapatite when filling bone defects in outpatient surgical practice dentistry. 22 patients with bone defects of various localization using osteoplastic materials were examined and treated. In our study, two groups were allocated on the etiology of bone loss: radicular cysts and chronic generalized periodontitis. Basic methods of diagnosis and monitoring of treatment in the work presented with the cone-beam computed tomography and digital orthopantomography. Application of the testing osteoplastic materials resulted in faster recovery times with a combination of bone defects using resorbable membranes or gel enriched fibrin. In all 22 patients both tested materials were well tolerated, allergic reactions were not identified. However, five patients with a history of endocrinological history, during which treatment material is applied on the basis non-demineralized bone collagen, the degree of osseointegration has been reduced by 25% compared to the somatic healthy patients. In 3 patients with a history of hematological history, during which the treatment was applied material on the basis of artificial hydroxyapatite, the regeneration of the bone defect was reduced by 20%, which suggests the influence of somatic condition of the patient on the regeneration of bone tissue. Currently, all patients are on dynamic monitoring, recurrence has been detected. Materials based on non-demineralized bone collagen and hydroxyapatite artificial equally successful during the replacement of the bone defect during surgery. However, the

  16. Porous calcium polyphosphate bone substitutes: additive manufacturing versus conventional gravity sinter processing-effect on structure and mechanical properties.

    PubMed

    Hu, Youxin; Shanjani, Yaser; Toyserkani, Ehsan; Grynpas, Marc; Wang, Rizhi; Pilliar, Robert

    2014-02-01

    Porous calcium polyphosphate (CPP) structures proposed as bone-substitute implants and made by sintering CPP powders to form bending test samples of approximately 35 vol % porosity were machined from preformed blocks made either by additive manufacturing (AM) or conventional gravity sintering (CS) methods and the structure and mechanical characteristics of samples so made were compared. AM-made samples displayed higher bending strengths (≈1.2-1.4 times greater than CS-made samples), whereas elastic constant (i.e., effective elastic modulus of the porous structures) that is determined by material elastic modulus and structural geometry of the samples was ≈1.9-2.3 times greater for AM-made samples. X-ray diffraction analysis showed that samples made by either method displayed the same crystal structure forming β-CPP after sinter annealing. The material elastic modulus, E, determined using nanoindentation tests also showed the same value for both sample types (i.e., E ≈ 64 GPa). Examination of the porous structures indicated that significantly larger sinter necks resulted in the AM-made samples which presumably resulted in the higher mechanical properties. The development of mechanical properties was attributed to the different sinter anneal procedures required to make 35 vol % porous samples by the two methods. A primary objective of the present study, in addition to reporting on bending strength and sample stiffness (elastic constant) characteristics, was to determine why the two processes resulted in the observed mechanical property differences for samples of equivalent volume percentage of porosity. An understanding of the fundamental reason(s) for the observed effect is considered important for developing improved processes for preparation of porous CPP implants as bone substitutes for use in high load-bearing skeletal sites.

  17. Evaluation of bone substitutes for treatment of peri-implant bone defects: biomechanical, histological, and immunohistochemical analyses in the rabbit tibia

    PubMed Central

    2016-01-01

    Purpose We sought to evaluate the effectiveness of bone substitutes in circumferential peri-implant defects created in the rabbit tibia. Methods Thirty rabbits received 45 implants in their left and right tibia. A circumferential bone defect (6.1 mm in diameter/4 mm depth) was created in each rabbit tibia using a trephine bur. A dental implant (4.1 mm × 8.5 mm) was installed after the creation of the defect, providing a 2-mm gap. The bone defect gaps between the implant and the bone were randomly filled according to the following groups: blood clot (CO), particulate Bio-Oss® (BI), and Bio-Oss® Collagen (BC). Ten animals were euthanized after periods of 15, 30, and 60 days. Biomechanical analysis by means of the removal torque of the implants, as well as histologic and immunohistochemical analyses for protein expression of osteocalcin (OC), Runx2, OPG, RANKL, and TRAP were evaluated. Results For biomechanics, BC showed a better biological response (61.00±15.28 Ncm) than CO (31.60±14.38 Ncm) at 30 days. Immunohistochemical analysis showed significantly different OC expression in CO and BC at 15 days, and also between the CO and BI groups, and between the CO and BC groups at 60 days. After 15 days, Runx2 expression was significantly different in the BI group compared to the CO and BC groups. RANKL expression was significantly different in the BI and CO groups and between the BI and BC groups at 15 days, and also between the BI and CO groups at 60 days. OPG expression was significantly higher at 60 days postoperatively in the BI group than the CO group. Conclusions Collectively, our data indicate that, compared to CO and BI, BC offered better bone healing, which was characterized by greater RUNX2, OC, and OPG immunolabeling, and required greater reversal torque for implant removal. Indeed, along with BI, BC presents promising biomechanical and biological properties supporting its possible use in osteoconductive grafts for filling peri-implant gaps. PMID:27382506

  18. 3D printing of mineral–polymer bone substitutes based on sodium alginate and calcium phosphate

    PubMed Central

    Egorov, Aleksey A; Fedotov, Alexander Yu; Mironov, Anton V; Popov, Vladimir K; Zobkov, Yury V

    2016-01-01

    We demonstrate a relatively simple route for three-dimensional (3D) printing of complex-shaped biocompatible structures based on sodium alginate and calcium phosphate (CP) for bone tissue engineering. The fabrication of 3D composite structures was performed through the synthesis of inorganic particles within a biopolymer macromolecular network during 3D printing process. The formation of a new CP phase was studied through X-ray diffraction, Fourier transform infrared spectroscopy and scanning electron microscopy. Both the phase composition and the diameter of the CP particles depend on the concentration of a liquid component (i.e., the “ink”). The 3D printed structures were fabricated and found to have large interconnected porous systems (mean diameter ≈800 μm) and were found to possess compressive strengths from 0.45 to 1.0 MPa. This new approach can be effectively applied for fabrication of biocompatible scaffolds for bone tissue engineering constructions. PMID:28144529

  19. 3D printing of mineral-polymer bone substitutes based on sodium alginate and calcium phosphate.

    PubMed

    Egorov, Aleksey A; Fedotov, Alexander Yu; Mironov, Anton V; Komlev, Vladimir S; Popov, Vladimir K; Zobkov, Yury V

    2016-01-01

    We demonstrate a relatively simple route for three-dimensional (3D) printing of complex-shaped biocompatible structures based on sodium alginate and calcium phosphate (CP) for bone tissue engineering. The fabrication of 3D composite structures was performed through the synthesis of inorganic particles within a biopolymer macromolecular network during 3D printing process. The formation of a new CP phase was studied through X-ray diffraction, Fourier transform infrared spectroscopy and scanning electron microscopy. Both the phase composition and the diameter of the CP particles depend on the concentration of a liquid component (i.e., the "ink"). The 3D printed structures were fabricated and found to have large interconnected porous systems (mean diameter ≈800 μm) and were found to possess compressive strengths from 0.45 to 1.0 MPa. This new approach can be effectively applied for fabrication of biocompatible scaffolds for bone tissue engineering constructions.

  20. Characterization of natural fibers and their application in bone grafting substitutes.

    PubMed

    Chandramohan, D; Marimuthu, K

    2011-01-01

    In the last decades, researchers have developed new materials to improve the quality of human life. Owing to the frequent occurrence of bone fractures, it is important to develop plate materials for the fixation of fractured bones. These plate materials have to be lightweight, compatible with human tissues and ought to allow stiffness. Natural fibers have the advantage that they are renewable resources and have marketing appeal. The Asian markets have been supplying natural fibers for many years, e.g., sisal, banana and roselle are common reinforcement in India. In this research, the fabrication of plate material from powdered natural fibers like sisal (Agave sisalana), banana (Musa sapientum) and roselle (Hibiscus sabdariffa), with bio-epoxy resin Grade 3554A and Hardner 3554B, using moulding method, is described. The present work deals with the prediction of flexural rigidity of the NFRP composite which is compared with that obtained using the ANSYS solution. They are found to be in good agreement. In this work, microstructure is scanned by the scanning electron microscope. The objective of this research was to utilize the advantages offered by renewable resources for the development of biocomposite materials based on biopolymers and natural fibers. In the future, this plate material externally coated with calcium phosphate and hydroxyapatite (hybrid) composite can be used for inside fixation and also external fixation of fractured bones.

  1. Calcium sulphate as a bone substitute for various osseous defects in conjunction with apicectomy.

    PubMed

    Murashima, Y; Yoshikawa, G; Wadachi, R; Sawada, N; Suda, H

    2002-09-01

    The purpose of this study was to investigate the effect of calcium sulphate on various osseous defects when used in conjunction with apicectomy. Mandibular third and fourth premolars of 11 beagle dogs were used. After root-canal treatment and apicectomy, three types of osseous defects were prepared on both sides of the mandible as follows: type 1, osseous defect communicating with the gingival sulcus: type 2, large osseous defect including two roots; type 3, 'through and through' osseous defect. The experimental side was allocated randomly, and the osseous defects were filled with medical grade calcium sulphate. The defects on the opposite side were left unfilled as controls. The dogs were sacrificed at 8 and 16 weeks postoperatively. Undemineralized sections were obtained and examined histomorphometrically. In type 1 defects, bone was not observed on the buccal side of the root on either experimental or control side at 8 and 16 weeks. In both type 2 and 3 defects, bone volume/tissue volume (BV/TV) values on the experimental side were significantly higher than those on the control side (P < 0.01), and mineral apposition rate (MAR) values on the experimental side were significantly higher than those on the control side (P < 0.01). The use of calcium sulphate was effective in bone regeneration on both large osseous defects and 'through and through' osseous defects. It was less effective in osseous defects communicating with the gingival sulcus.

  2. Induction of multinucleated giant cells in response to small sized bovine bone substitute (Bio-Oss™) results in an enhanced early implantation bed vascularization

    PubMed Central

    Barbeck, M.; Udeabor, S. E.; Lorenz, J.; Kubesch, A.; Choukroun, J.; Sader, R. A.; Kirkpatrick, C. J.; Ghanaati, S.

    2014-01-01

    Purpose: The host tissue reaction to the xenogeneic bone substitute Bio-Oss™ (Geistlich Biomaterials, Wolhousen, Switzerland) was investigated focusing on the participating inflammatory cells and implantation bed vascularization. Materials and Methods: Bio-Oss™ was implanted subcutaneously into CD1 mice for up to 60 days and analyzed by means of specialized histological and histomorphometrical techniques after explantation. Results: Bio-Oss™ induced within the first 15 days an early high vascularization combined with a marked presence of multinucleated giant cells. The latter cells were associated mainly with the smaller sized granules within the implantation bed. Toward the end of the study the number of multinucleated giant cells decreased while the tissue reaction to the larger granules was mainly mononuclear. Conclusion: The results of the present study showed that smaller xenogeneic bone substitute granules induce multinucleated giant cells, whereas the larger-sized ones became integrated within the implantation bed by means of a mononuclear cell-triggered granulation tissue. Obviously, the presence of multinucleated giant cells within biomaterial implantation beds is not only related to the type of synthetic bone substitute material, but also to the granule size of the natural-based xenogeneic bone substitute material. PMID:25593863

  3. Ridge preservation using an in situ hardening biphasic calcium phosphate (β-TCP/HA) bone graft substitute-a clinical, radiological, and histological study.

    PubMed

    Kakar, Ashish; Rao, Bappanadu H Sripathi; Hegde, Shashikanth; Deshpande, Nikhil; Lindner, Annette; Nagursky, Heiner; Patney, Aditya; Mahajan, Harsh

    2017-12-01

    Post-Extraction ridge preservation using bone graft substitutes is a conservative technique to maintain the width of the alveolar ridge. The objective of the present study was to evaluate an in situ hardening biphasic (HA/β-TCP) bone graft substitutes for ridge preservation without primary wound closure or a dental membrane. A total of 15 patients reported for tooth extraction were enrolled in this study. Implants were placed in average 5.2 ± 2 months after socket grafting. At this visit, Cone Beam CT (CBCT) images and core biopsies were taken. Implant stability (ISQ) was assessed at the insertion as well as at the day of final restoration. CBCT data revealed 0.79 ± 0.73 mm ridge width reduction from grafting to implant placement. Histomorphometric analysis of core biopsy samples revealed in average 21.34 ± 9.14% of new bone in the grafted sites. Primary implant stability was high (ISQ levels 70.3 ± 9.6) and further increased until final restoration. The results of this study show that grafting of intact post-extraction sockets using a biphasic in situ hardening bone graft substitute results in an effective preservation of the ridge contour and sufficient new bone formation in the grafted sites, which is imperative for successful implant placement.

  4. [Erythrocyte substitution and isoagglutinin titer following ABO-incompatible bone marrow transplantation].

    PubMed

    Henneberg-Quester, K B; Luboldt, W; Schaefer, U W; Beelen, D W; Quabeck, K

    1990-01-01

    About 2 or 3 weeks after transplantation, even ABO-Incompatible bone marrow shows a successful graft. Haemopoiesis is not always free of problems. Suppression of erythropoiesis is caused by persistently incompatible agglutinins. Patient's well-being is limited by longer periods of low levels of haemoglobin concentration. Long-lasting need for transfusions is related to the well-known risk of infections. A procedure to eliminate the residual titers of alloantibodies should be discussed in time with the staff of the transfusion department.

  5. Mineralization of Synthetic Polymer Scaffolds: A Bottom-upApproach for the Development of Artificial Bone

    SciTech Connect

    Song, Jie; Viengkham, Malathong; Bertozzi, Carolyn R.

    2004-09-27

    The controlled integration of organic and inorganic components confers natural bone with superior mechanical properties. Bone biogenesis is thought to occur by templated mineralization of hard apatite crystals by an elastic protein scaffold, a process we sought to emulate with synthetic biomimetic hydrogel polymers. Crosslinked polymethacrylamide and polymethacrylate hydrogels were functionalized with mineral-binding ligands and used to template the formation of hydroxyapatite. Strong adhesion between the organic and inorganic materials was achieved for hydrogels functionalized with either carboxylate or hydroxy ligands. The mineral-nucleating potential of hydroxyl groups identified here broadens the design parameters for synthetic bone-like composites and suggests a potential role for hydroxylated collagen proteins in bone mineralization.

  6. Bioactive calcium sulfate/magnesium phosphate cement for bone substitute applications.

    PubMed

    Yang, Guangyong; Liu, Jianli; Li, Fan; Pan, Zongyou; Ni, Xiao; Shen, Yue; Xu, Huazi; Huang, Qing

    2014-02-01

    A novel calcium sulfate/magnesium phosphate cement (CSMPC) composite was prepared and studied in the present work. The physical properties including the phases, the microstructures, the setting properties and the compressive strengths of the CSMPCs were studied. The bio-performances of the CSMPCs were comprehensively evaluated using in vitro simulated body fluid (SBF) method and in vitro cell culture. The dependence of the physical and chemical properties of the CSMPC on its composition and microstructure was studied in detail. It is found that the CSMPC composites exhibited mediate setting times (6-12 min) compared to the calcium sulfate (CS) and the magnesium phosphate cement (MPC). They showed an encapsulation structure in which the unconverted hexagonal prism CSH particles were embedded in the xerogel-like MPC matrix. The phase compositions and the mechanical properties of the CSMPCs were closely related to the content of MPC and the hardening process. The CSMPCs exhibited excellent bioactivity and good biocompatibility to support the cells to attach and proliferate on the surface. The CSMPC composite has the potential to serve as bone grafts for the bone regeneration.

  7. Posterolateral spinal fusion in a rabbit model using a collagen–mineral composite bone graft substitute

    PubMed Central

    Vizesi, F.; Cornwall, G. B.; Bell, D.; Oliver, R.; Yu, Y.

    2009-01-01

    Choosing the appropriate graft material to participate in the healing process in posterolateral spinal fusion continues to be a challenge. Combining synthetic graft materials with bone marrow aspirate (BMA) and autograft is a reasonable treatment option for surgeons to potentially reduce or replace the need for autograft. FormaGraft, a bone graft material comprising 12% bovine-derived collagen and 88% ceramic in the form of hydroxyapatite (HAp) and beta tricalcium phosphate (β-TCP) was evaluated in three possible treatment modalities for posterior spinal fusion in a standard rabbit model. These three treatment groups were FormaGraft alone, FormaGraft soaked in autogenous BMA, and FormaGraft with BMA and iliac crest autograft. No statistically demonstrable benefits or adverse effects of the addition of BMA were found in the current study based on macroscopic, radiology or mechanical data. This may reflect, in part, the good to excellent results of the collagen HA/TCP composite material alone in a well healing bony bed. Histology did, however, reveal a benefit with the use of BMA. Combining FormaGraft with autograft and BMA achieved results equivalent to autograft alone. The mineral and organic nature of the material provided a material that facilitated fusion between the transverse processes in a standard preclinical posterolateral fusion model. PMID:19475437

  8. [Ionomer cement as bone substitute in the middle ear of the rabbit].

    PubMed

    Geyer, G

    1997-04-01

    Ionomer-based cements are obtained by the reaction of an aluminum-fluoro-silicate glass with a polyalcenoic acid. During setting and hardening the cement bonds closely with adjacent hard tissue. The previous implantation of this material in the baboon tibia has held great promise as a possible use in bone replacement. In the present study the cement was tested concerning its biocompatibility and biostability in the middle ears of 64 rabbits. Viscid cement paste was inserted into the epitympanic space of each animal. A preformed cement strut was then placed to serve as a columella between the eardrum and stapes footplate. During a subsequent interval of 28 days up to 2 years middle ear specimens were evaluated under a surgical microscope, following which histologic sections were studied under light microscopic conditions. Findings demonstrated that after insertion of freshly mixed cement a firm adhesion to bone developed that proved to be biocompatible and biostable over time. After 28 days the preformed and fully hardened implants were overgrown by a delicate mucosa normally present in the middle ear. No evidence for any rejection of the implants could be found. The experience available to date indicates that ionomer cement is biocompatible and biostable, easy to handle and workable without splintering. With appropriate use it represents a useful implant material in surgery of the head and neck.

  9. SU-C-213-01: 3D Printed Patient Specific Phantom Composed of Bone and Soft Tissue Substitute Plastics for Radiation Therapy

    SciTech Connect

    Ehler, E; Sterling, D; Higgins, P

    2015-06-15

    Purpose: 3D printed phantoms constructed of multiple tissue approximating materials could be useful in both clinical and research aspects of radiotherapy. This work describes a 3D printed phantom constructed with tissue substitute plastics for both bone and soft tissue; air cavities were included as well. Methods: 3D models of an anonymized nasopharynx patient were generated for air cavities, soft tissues, and bone, which were segmented by Hounsfield Unit (HU) thresholds. HU thresholds were chosen to define air-to-soft tissue boundaries of 0.65 g/cc and soft tissue-to-bone boundaries of 1.18 g/cc based on clinical HU to density tables. After evaluation of several composite plastics, a bone tissue substitute was identified as an acceptable material for typical radiotherapy x-ray energies, composed of iron and PLA plastic. PET plastic was determined to be an acceptable soft tissue substitute. 3D printing was performed on a consumer grade dual extrusion fused deposition model 3D printer. Results: MVCT scans of the 3D printed heterogeneous phantom were acquired. Rigid image registration of the patient and the 3D printed phantom scans was performed. The average physical density of the soft tissue and bone regions was 1.02 ± 0.08 g/cc and 1.39 ± 0.14 g/cc, respectively, for the patient kVCT scan. In the 3D printed phantom MVCT scan, the average density of the soft tissue and bone was 1.01 ± 0.09 g/cc and 1.44 ± 0.12 g/cc, respectively. Conclusion: A patient specific phantom, constructed of heterogeneous tissue substitute materials was constructed by 3D printing. MVCT of the 3D printed phantom showed realistic tissue densities were recreated by the 3D printing materials. Funding provided by intra-department grant by University of Minnesota Department of Radiation Oncology.

  10. Mineral distribution of artificial dentinal caries lesions after treatment with fluoride agents in combination with saliva substitutes.

    PubMed

    Tschoppe, Peter; Meyer-Lueckel, Hendrik

    2011-08-01

    Some saliva substitutes have been shown to demineralize dentine in vitro. This effect is counteracted by the application of various fluorides. In contrast, remineralizing saliva substitutes might be supported by these treatments, depending on the dynamics during remineralization. The aim of this in vitro study was to evaluate the effects of fluoride mouthrinses or gels in combination with de-/remineralizing saliva substitutes on dentinal subsurface lesions. Demineralized bovine dentine specimens were stored either in mineral water [saturation with respect to octacalcium phosphate (S(OCP)): 0.7], Glandosane (G, S(OCP): 0.3) or in a modified saliva substitute Saliva natura (SN, S(OCP): 1.9) for five weeks (37°C). Fluoride agents were applied twice daily for 10 min (n = 15/group): no treatment, Meridol mouthrinse, Elmex sensitive solution, ProSchmelz fluoride gel, Elmex gelée. After storage thin sections were prepared and mineral losses before and after storage were evaluated from microradiographs. Specimens stored in G alone showed significantly higher mineral loss compared to those stored in water, SN or G in combination with any additional treatment (p < 0.05). Storage in SN and treatment with ProSchmelz fluoride gel led to significantly higher remineralization compared to all other groups (p < 0.05) and resulted in distinct mineral gain within the lesion body. Under the in vitro conditions chosen, use of fluoride agents in combination with a demineralizing saliva substitute resulted in reduced mineral loss. Storage in modified Saliva natura in combination with the application of ProSchmelz fluoride gel induced the most pronounced remineralization also of deeper lesion areas. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Mimicking nanofibrous hybrid bone substitute for mesenchymal stem cells differentiation into osteogenesis.

    PubMed

    Gandhimathi, Chinnasamy; Venugopal, Jayarama; Ravichandran, Rajeswari; Sundarrajan, Subramanian; Suganya, Shanmugavel; Ramakrishna, Seeram

    2013-06-01

    Mimicking hybrid extracellular matrix is one of the main challenges for bone tissue engineering (BTE). Biocompatible polycaprolactone/poly(α,β)-DL-aspartic acid/collagen nanofibrous scaffolds were fabricated by electrospinning and nanohydroxyapatite (n-HA) was deposited by calcium phosphate dipping method for BTE. Human mesenchymal stem cells (hMSCs) were cultured on these hybrid scaffolds to investigate the cell proliferation, osteogenic differentiation by alkaline phosphatase activity, mineralization, double immunofluorescent staining using CD90 and expression of osteocalcin. The present study indicated that the PCL/PAA/collagen/n-HA scaffolds promoted greater osteogenic differentiation of hMSCs, proving to be a potential hybrid scaffolds for BTE. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Initial glenoid fixation using two different reverse shoulder designs with an equivalent center of rotation in a low-density and high-density bone substitute.

    PubMed

    Stroud, Nicholas J; DiPaola, Matthew J; Martin, Brian L; Steiler, Cindy A; Flurin, Pierre-Henri; Wright, Thomas W; Zuckerman, Joseph D; Roche, Christopher P

    2013-11-01

    Numerous glenoid implant designs have been introduced into the global marketplace in recent years; however, little comparative biomechanical data exist to substantiate one design consideration over another. This study dynamically evaluated reverse shoulder glenoid baseplate fixation and compared the initial fixation associated with 2 reverse shoulder designs having an equivalent center of rotation in low-density and high-density bone substitute substrates. Significant differences in fixation were observed between implant designs, where the circular-porous reverse shoulder was associated with approximately twice the micromotion per equivalent test than the oblong-grit-blasted design. Additionally, 6 of the 7 circular-porous reverse shoulders failed catastrophically in the low-density bone model at an average of 2603 ± 981 cycles. None of the oblong-grit-blasted designs failed in the low-or high-density bone models and none of the circular-porous designs failed in the high-density bone models after 10,000 cycles of loading. These results demonstrate that significant differences in initial fixation exist between reverse shoulder implants having an equivalent center of rotation and suggest that design parameters, other than the position of the center of rotation, significantly affect fixation in low-density and high-density polyurethane bone substitutes. Subtle changes in glenoid baseplate design can dramatically affect fixation, particularly in low-density bone substitutes that are intended to simulate the bone quality of the recipient population for reverse shoulders. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  13. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 16: bone graft extenders and substitutes as an adjunct for lumbar fusion.

    PubMed

    Kaiser, Michael G; Groff, Michael W; Watters, William C; Ghogawala, Zoher; Mummaneni, Praveen V; Dailey, Andrew T; Choudhri, Tanvir F; Eck, Jason C; Sharan, Alok; Wang, Jeffrey C; Dhall, Sanjay S; Resnick, Daniel K

    2014-07-01

    In an attempt to enhance the potential to achieve a solid arthrodesis and avoid the morbidity of harvesting autologous iliac crest bone (AICB) for a lumbar fusion, numerous alternatives have been investigated. The use of these fusion adjuncts has become routine despite a lack of convincing evidence demonstrating a benefit to justify added costs or potential harm. Potential alternatives to AICB include locally harvested autograft, calcium-phosphate salts, demineralized bone matrix (DBM), and the family of bone morphogenetic proteins (BMPs). In particular, no option has created greater controversy than the BMPs. A significant increase in the number of publications, particularly with respect to the BMPs, has taken place since the release of the original guidelines. Both DBM and the calciumphosphate salts have demonstrated efficacy as a graft extender or as a substitute for AICB when combined with local autograft. The use of recombinant human BMP-2 (rhBMP-2) as a substitute for AICB, when performing an interbody lumbar fusion, is considered an option since similar outcomes have been observed; however, the potential for heterotopic bone formation is a concern. The use of rhBMP-2, when combined with calcium phosphates, as a substitute for AICB, or as an extender, when used with local autograft or AICB, is also considered an option as similar fusion rates and clinical outcomes have been observed. Surgeons electing to use BMPs should be aware of a growing body of literature demonstrating unique complications associated with the use of BMPs.

  14. Histological and histomorphometrical analysis of a silica matrix embedded nanocrystalline hydroxyapatite bone substitute using the subcutaneous implantation model in Wistar rats.

    PubMed

    Ghanaati, Shahram; Orth, Carina; Barbeck, Mike; Willershausen, Ines; Thimm, Benjamin W; Booms, Patrick; Stübinger, Stefan; Landes, Constantin; Sader, Robert Anton; Kirkpatrick, Charles James

    2010-06-01

    The clinical suitability of a bone substitute material is determined by the ability to induce a tissue reaction specific to its composition. The aim of this in vivo study was to analyze the tissue reaction to a silica matrix-embedded, nanocrystalline hydroxyapatite bone substitute.The subcutaneous implantation model in Wistar rats was chosen to assess the effect of silica degradation on the vascularization of the biomaterial and its biodegradation within a time period of 6 months. Already at day 10 after implantation, histomorphometrical analysis showed that the vascularization of the implantation bed reached its peak value compared to all other time points. Both vessel density and vascularization significantly decreased until day 90 after implantation. In this time period, the bone substitute underwent a significant degradation initiated by TRAP-positive and TRAP-negative multinucleated giant cells together with macrophages and lymphocytes. Although no specific tissue reaction could be related to the described silica degradation, the biomaterial was close to being fully degraded without a severe inflammatory response. These characteristics are advantageous for bone regeneration and remodeling processes.

  15. The biomechanical effect of artificial and human bone density on stopping and stripping torque during screw insertion.

    PubMed

    Tsuji, Matthew; Crookshank, Meghan; Olsen, Michael; Schemitsch, Emil H; Zdero, Rad

    2013-06-01

    Orthopedic surgeons apply torque to metal screws manually by "subjective feel" to obtain adequate fracture fixation, i.e. stopping torque, and attempt to avoid accidental over-tightening that leads to screw-bone interface failure, i.e. stripping torque. Few studies have quantified stripping torque in human bone, and only one older study from 1980 reported stopping/ stripping torque ratio. The present aim was to measure stopping and stripping torque of cortical and cancellous screws in artificial and human bone over a wide range of densities. Sawbone blocks were obtained having densities from 0.08 to 0.80g/cm(3). Sixteen fresh-frozen human femurs of known standardized bone mineral density (sBMD) were also used. Using a torque screwdriver, 3.5-mm diameter cortical screws and 6.5-mm diameter cancellous screws were inserted for adequate tightening as determined subjectively by an orthopedic surgeon, i.e. stopping torque, and then further tightened until failure of the screw-bone interface, i.e. stripping torque. There were weak (R=0.25) to strong (R=0.99) linear correlations of absolute and normalized torque vs. density or sBMD. Maximum stopping torques normalized by screw thread area engaged by the host material were 15.2N/mm (cortical screws) and 13.4N/mm (cancellous screws) in sawbone blocks and 20.9N/mm (cortical screws) and 6.1N/mm (cancellous screws) in human femurs. Maximum stripping torques normalized by screw thread area engaged by the host material were 23.4N/mm (cortical screws) and 16.8N/mm (cancellous screws) in sawbone blocks and 29.3N/mm (cortical screws) and 8.3N/mm (cancellous screws) in human femurs. Combined average stopping/ stripping torque ratios were 80.8% (cortical screws) and 76.8% (cancellous screws) in sawbone blocks, as well as 66.6% (cortical screws) and 84.5% (cancellous screws) in human femurs. Surgeons should be aware of stripping torque limits for human femurs and monitor stopping torque during surgery. This is the first study of the

  16. Physico-chemical and in vitro biological study of zinc-doped calcium sulfate bone substitute.

    PubMed

    Hesaraki, Saeed; Nemati, Roghayeh; Nazarian, Hamid

    2009-10-01

    In the present study, series of Zn incorporated calcium sulfate bone cements, with different amounts of doped Zn(0, 0.74, 1.97, 3.05, 4.21 wt %) were prepared by mixing a calcium sulfate hemihydrate powder and solutions of zinc sulfate, and the effect of zinc-doping on some physical, physico-chemical, and biological properties of the cements were investigated. Pure calcium sulfate cement was also made as control, with the mentioned powder and distilled water as liquid phase. The initial setting time and compressive strength of the cement significantly changed from 17 min and 3.2 MPa for the pure calcium sulfate to 6 min and 6 MPa for the Zn-added calcium sulfate, respectively. Compared to pure calcium sulfate, more gypsum precipitates were formed in the zinc sulfate added samples with a morphology of thin, elongated, and rod-shaped crystals. The biological properties of the samples were analyzed in the terms of cell viability and cell activity on human osteosarcoma (G-292) using MTT assay and alkaline phosphatase (ALP) activity in the cell culture medium. The best increased cell density and ALP activity were achieved for the calcium sulfate cement with a content of 0.74 wt % Zn, whereas a toxic behavior was observed for the samples with Zn concentrations more than 1.97%. (c) 2009 Wiley Periodicals, Inc.

  17. Human Bone Derived Collagen for the Development of an Artificial Corneal Endothelial Graft. In Vivo Results in a Rabbit Model

    PubMed Central

    Vázquez, Natalia; Chacón, Manuel; Rodríguez-Barrientos, Carlos A.; Merayo-Lloves, Jesús; Naveiras, Miguel; Baamonde, Begoña; Alfonso, Jose F.; Zambrano-Andazol, Iriana; Riestra, Ana C.; Meana, Álvaro

    2016-01-01

    Corneal keratoplasty (penetrating or lamellar) using cadaveric human tissue, is nowadays the main treatment for corneal endotelial dysfunctions. However, there is a worldwide shortage of donor corneas available for transplantation and about 53% of the world’s population have no access to corneal transplantation. Generating a complete cornea by tissue engineering is still a tough goal, but an endothelial lamellar graft might be an easier task. In this study, we developed a tissue engineered corneal endothelium by culturing human corneal endothelial cells on a human purified type I collagen membrane. Human corneal endothelial cells were cultured from corneal rims after corneal penetrating keratoplasty and type I collagen was isolated from remnant cancellous bone chips. Isolated type I collagen was analyzed by western blot, liquid chromatography -mass spectrometry and quantified using the exponentially modified protein abundance index. Later on, collagen solution was casted at room temperature obtaining an optically transparent and mechanically manageable membrane that supports the growth of human and rabbit corneal endothelial cells which expressed characteristic markers of corneal endothelium: zonula ocluddens-1 and Na+/K+ ATPase. To evaluate the therapeutic efficiency of our artificial endothelial grafts, human purified type I collagen membranes cultured with rabbit corneal endothelial cells were transplanted in New Zealand white rabbits that were kept under a minimal immunosuppression regimen. Transplanted corneas maintained transparency for as long as 6 weeks without obvious edema or immune rejection and maintaining the same endothelial markers that in a healthy cornea. In conclusion, it is possible to develop an artificial human corneal endothelial graft using remnant tissues that are not employed in transplant procedures. This artificial endothelial graft can restore the integrality of corneal endothelium in an experimental model of endothelial dysfunction

  18. Bioactive glass as a bone substitute for spinal fusion in adolescent idiopathic scoliosis: a comparative study with iliac crest autograft.

    PubMed

    Ilharreborde, Brice; Morel, Etienne; Fitoussi, Franck; Presedo, Ana; Souchet, Philippe; Penneçot, Georges-François; Mazda, Keyvan

    2008-01-01

    Iliac crest autograft is currently the gold standard material for spinal fusion. However, its use is limited by additional operative time, increased blood loss, and morbidity. Recently, a synthetic osteoconductive bone graft material composed of bioactive glass has been described, with high effectiveness in animal models. Its ability to achieve spinal fusion in human has never been reported. The aim of this study was to compare bioactive glass and iliac crest autograft as bone substitutes in the treatment thoracic adolescent idiopathic scoliosis (AIS). Eighty-eight consecutive patients underwent posterior spinal fusion for progressive thoracic AIS. There were 2 study groups based on the type of bone graft used: iliac crest autograft (n = 40) or bioglass (n = 48). A minimum 2-year follow-up was required. Medical data and radiographs were retrospectively analyzed and compared using unpaired t test and Mann-Whitney U test. Mean follow-up was 40 months in the autograft group and 38 months in the bioglass group. In the autograft group, there were 2 infections (5%) and 3 mechanical failures (7.5%). One infection (2%) and 1 early mechanical failure (2%) occurred in the bioglass group. Loss of correction of the main thoracic curve between immediate postoperative and latest follow-up averaged 15.5% for autograft group and 11% for the bioglass group (P = 0.025). The mean (+/-SD) gain of frontal balance between immediate postoperative latest follow-up was 0.8 (+/-9.3) mm in the autograft group and 8.1 (+/-12) mm for the bioglass group (P = 0.005). Results of this retrospective study suggest that bioglass is as effective as iliac crest graft to achieve fusion and maintain correction in AIS. Less complications were seen in the bioactive glass group, but the difference did not reach statistical significance. Bioactive glass can be proposed in the treatment of AIS, avoiding the morbidity of iliac crest harvesting. However, clinical and radiological outcomes need to be confirmed

  19. Biofabrication of a PLGA-TCP-based porous bioactive bone substitute with sustained release of icaritin.

    PubMed

    Xie, Xin-Hui; Wang, Xin-Luan; Zhang, Ge; He, Yi-Xin; Leng, Yang; Tang, Ting-Ting; Pan, Xiaohua; Qin, Ling

    2015-08-01

    A phytomolecule, icaritin, has been identified and shown to be osteopromotive for the prevention of osteoporosis and osteonecrosis. This study aimed to produce a bioactive poly (l-lactide-co-glycolide)-tricalcium phosphate (PLGA-TCP)-based porous scaffold incorporating the osteopromotive phytomolecule icaritin, using a fine spinning technology. Both the structure and the composition of icaritin-releasing PLGA-TCP-based scaffolds were evaluated by scanning electron microscopy (SEM). The porosity was quantified by both water absorption and micro-computed tomography (micro-CT). The mechanical properties were evaluated using a compression test. In vitro release of icaritin from the PLGA-TCP scaffold was quantified by high-performance liquid chromatography (HPLC). The attachment, proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) on the composite scaffold were evaluated. Both an in vitro cytotoxicity test and an in vivo test via muscular implantation were conducted to confirm the scaffold's biocompatibility. The results showed that the PLGA-TCP-icaritin composite scaffold was porous, with interconnected macro- (about 480 µm) and micropores (2-15 µm). The mechanical properties of the PLGA-TCP-icaritin scaffold were comparable with those of the pure PLGA-TCP scaffold, yet was spinning direction-dependent. Icaritin content was detected in the medium and increased with time. The PLGA-TCP-icaritin scaffold facilitated the attachment, proliferation and osteogenic differentiation of BMSCs. In vitro cytotoxicity test and in vivo intramuscular implantation showed that the composite scaffold had no toxicity with good biocompatibility. In conclusion, an osteopromotive phytomolecule, icaritin, was successfully incorporated into PLGA-TCP to form an innovative porous composite scaffold with sustained release of osteopromotive icaritin, and this scaffold had good biocompatibility and osteopromotion, suggesting its potential for orthopaedic

  20. Fabrication of calcium phosphate–calcium sulfate injectable bone substitute using hydroxy-propyl-methyl-cellulose and citric acid

    PubMed Central

    Thai, Van Viet

    2010-01-01

    In this study, an injectable bone substitute (IBS) consisting of citric acid, chitosan, and hydroxyl propyl methyl cellulose (HPMC) as the liquid phase and tetra calcium phosphate (TTCP), dicalcium phosphate dihydrate (DCPD) and calcium sulfate dehydrate (CSD, CaSO4·2H2O) powders as the solid phase, were fabricated. Two groups were classified based on the percent of citric acid in the liquid phase (20, 40 wt%). In each groups, the HPMC percentage was 0, 2, and 4 wt%. An increase in compressive strength due to changes in morphology was confirmed by scanning electron microscopy images. A good conversion rate of HAp at 20% citric acid was observed in the XRD profiles. In addition, HPMC was not obviously affected by apatite formation. However, both HPMC and citric acid increased the compressive strength of IBS. The maximum compressive strength for IBS was with 40% citric acid and 4% HPMC after 14 days of incubation in 100% humidity at 37°C. PMID:20333539

  1. Fabrication of calcium phosphate-calcium sulfate injectable bone substitute using hydroxy-propyl-methyl-cellulose and citric acid.

    PubMed

    Thai, Van Viet; Lee, Byong-Taek

    2010-06-01

    In this study, an injectable bone substitute (IBS) consisting of citric acid, chitosan, and hydroxyl propyl methyl cellulose (HPMC) as the liquid phase and tetra calcium phosphate (TTCP), dicalcium phosphate dihydrate (DCPD) and calcium sulfate dehydrate (CSD, CaSO4 x 2H2O) powders as the solid phase, were fabricated. Two groups were classified based on the percent of citric acid in the liquid phase (20, 40 wt%). In each groups, the HPMC percentage was 0, 2, and 4 wt%. An increase in compressive strength due to changes in morphology was confirmed by scanning electron microscopy images. A good conversion rate of HAp at 20% citric acid was observed in the XRD profiles. In addition, HPMC was not obviously affected by apatite formation. However, both HPMC and citric acid increased the compressive strength of IBS. The maximum compressive strength for IBS was with 40% citric acid and 4% HPMC after 14 days of incubation in 100% humidity at 37 degrees C.

  2. The effect of layer-by-layer chitosan-hyaluronic acid coating on graft-to-bone healing of a poly(ethylene terephthalate) artificial ligament.

    PubMed

    Li, Hong; Ge, Yunsheng; Zhang, Pengyun; Wu, Lingxiang; Chen, Shiyi

    2012-01-01

    Surface coating with an organic layer-by-layer self-assembled template of chitosan and hyaluronic acid on a poly(ethylene terephthalate) (PET) artificial ligament was designed for the promotion and enhancement of graft-to-bone healing after artificial ligament implantation in a bone tunnel. The results of in vitro culturing of MC3T3-E1 mouse osteoblastic cells supported the hypothesis that the layer-by-layer coating of chitosan and hyaluronic acid could promote the cell compatibility of grafts and could promote osteoblast proliferation. A rabbit extra-articular tendon-to-bone healing model was used to evaluate the effect of this kind of surface-modified stainless artificial ligament in vivo. The final results proved that this organic compound coating could significantly promote and enhance new bone formation at the graft-bone interface histologically and, correspondingly, the experimental group with coating had significantly higher biomechanical properties compared with controls at 8 weeks (P < 0.05).

  3. Genomic profiling of bone and soft tissue tumors with supernumerary ring chromosomes using tiling resolution bacterial artificial chromosome microarrays.

    PubMed

    Heidenblad, M; Hallor, K H; Staaf, J; Jönsson, G; Borg, A; Höglund, M; Mertens, F; Mandahl, N

    2006-11-09

    Ring chromosomes and/or giant marker chromosomes have been observed in a variety of human tumor types, but they are particularly common in a subgroup of mesenchymal tumors of low-grade or borderline malignancy. These rings and markers have been shown to contain amplified material predominantly from 12q13-15, but also sequences from other chromosomes. Such amplified sequences were mapped in detail by genome-wide array comparative genomic hybridization in ring-containing tumor samples from soft tissue (n = 15) and bone (n = 6), using tiling resolution microarrays, encompassing 32 433 bacterial artificial chromosome clones. The DNA copy number profiles revealed multiple amplification targets, in many cases highly discontinuous, leading to delineation of large numbers of very small amplicons. A total number of 356 (median size: 0.64 Mb) amplicons were seen in the soft tissue tumors and 90 (median size: 1.19 Mb) in the bone tumors. Notably, more than 40% of all amplicons in both soft tissue and bone tumors were mapped to chromosome 12, and at least one of the previously reported recurrent amplifications in 12q13.3-14.1 and 12q15.1, including SAS and CDK4, and MDM2, respectively, were present in 85% of the soft tissue tumors and in all of the bone tumors. Although chromosome 12 was the only chromosome displaying recurrent amplification in the bone tumors, the soft tissue tumors frequently showed recurrent amplicons mapping to other chromosomes, that is, 1p32, 1q23-24, 3p11-12, 6q24-25 and 20q11-12. Of particular interest, amplicons containing genes involved in the c-jun NH2-terminal kinase/mitogen-activated protein kinase pathway, that is, JUN in 1p32 and MAP3K7IP2 (TAB2) in 6q24-25, were found to be independently amplified in eight of 11 cases with 12q amplification, providing strong support for the notion that aberrant expression of this pathway is an important step in the dedifferentiation of liposarcomas.

  4. Silicate-substituted calcium phosphate as a bone void filler after kyphoplasty in a young patient with multiple compression fractures due to osteogenesis imperfecta variant: case report.

    PubMed

    Hardenbrook, Mitchell A; Lombardo, Sergio R

    2006-12-15

    Kyphoplasty can be used to treat compression fractures resulting from a variety of causes. The use of polymethyl methacrylate (PMMA) in conjunction with kyphoplasty has many risks and potential complications, however, particularly in the younger patient population. Silicate-substituted calcium phosphate (Actifuse Synthetic Bone Graft; Apatech, Ltd.) is an alternative to PMMA that provides immediate pain relief and the ability to heal and incorporate within the vertebral body.

  5. In vitro assessment of Function Graded (FG) artificial Hip joint stem in terms of bone/cement stresses: 3D Finite Element (FE) study

    PubMed Central

    2013-01-01

    Background Stress shielding in the cemented hip prosthesis occurs due to the mismatching in the mechanical properties of metallic stem and bone. This mismatching in properties is considered as one of the main reasons for implant loosening. Therefore, a new stem material in orthopedic surgery is still required. In the present study, 3D finite element modeling is used for evaluating the artificial hip joint stem that is made of Function Graded (FG) material in terms of joint stress distributions and stem length. Method 3D finite element models of different stems made of two types of FG materials and traditional stems made of Cobalt Chromium alloy (CoCrMo) and Titanium alloy (Ti) were developed using the ANSYS Code. The effects on the total artificial hip joint stresses (Shear stress and Von Mises stresses at bone cement, Von Mises stresses at bone and stem) due to using the proposed FG materials stems were investigated. The effects on the total artificial hip joint system stresses due to using different stem lengths were investigated. Results Using FG stem (with low stiffness at stem distal end and high stiffness at its proximal end) resulted in a significant reduction in shear stress at the bone cement/stem interface. Also, the Von Mises stresses at the bone cement and stem decrease significantly when using FG material instead of CoCrMo and Ti alloy. The stresses’ distribution along the bone cement length when using FG material was found to be more uniform along the whole bone cement compared with other stem materials. These more uniform stresses will help in the reduction of the artificial hip joint loosening rate and improve its short and long term performance. Conclusion FE results showed that using FG stem increases the resultant stresses at the femur bone (reduces stress shielding) compared to metallic stem. The results showed that the stem length has significant effects on the resultant shear and Von Mises stresses at bone, stem and bone cement for all types

  6. Beta-tricalcium phosphate combined with recombinant human bone morphogenetic protein-2: a substitute for autograft, used for packing interbody fusion cages in the canine lumbar spine.

    PubMed

    Ohyama, Takashiro; Kubo, Yoshichika; Iwata, Hiroo; Taki, Waro

    2004-05-01

    Beta-tricalcium phosphate (beta-TCP) combined with recombinant human bone morphogenetic protein-2 (BMP-2) was examined as a substitute for autograft for packing into interbody fusion cages in the canine lumbar spine model. Discectomy and interbody cage fusion were performed at three disc spaces in eight dogs. Examination of microradiographs and histological sections of the lumbar spine at 16 weeks postsurgery revealed three fusions in the autograft cages (Group A), three in the beta-TCP cages (Group B), and five in the beta-TCP-BMP-2 cages (Group C). The mean percentage of trabecular bone area in the cages was 51.9% in Group A, 48.8% in Group B, and 65.6% in Group C. Mean percentage of trabecular bone formation and mechanical stiffness were highest in the cages filled with beta-TCP and BMP-2. Combination of BMP to beta-TCP may act as an osteoconductive and osteoinductive bone graft substitute in clinical spine surgery.

  7. Bone-forming capacity of mesenchymal stromal cells when cultured in the presence of human platelet lysate as substitute for fetal bovine serum.

    PubMed

    Prins, Henk-Jan; Rozemuller, Henk; Vonk-Griffioen, Simone; Verweij, Vivienne G M; Dhert, Wouter J A; Slaper-Cortenbach, Ineke C M; Martens, Anton C M

    2009-12-01

    In tissue engineering, strategies are being developed to repair large bone defects by combining biomaterials and bone marrow-derived multipotent mesenchymal stromal cells (MSCs). For expansion of MSCs under good manufacturing practice conditions, human platelet lysate (PL) can serve as substitute for fetal bovine serum (FBS) in culture media. We compared the in vivo bone-forming capacity of passage 3 MSCs cultured with either PL or FBS for nine different human donors. We also tested the growth kinetics, antigen expression profile, and the multilineage differentiation capacity in vitro of these MSCs. The in vivo bone-forming capacity was determined by seeding culture-expanded MSCs onto biphasic calcium phosphate scaffolds. Hybrid constructs were implanted subcutaneously in nude mice, retrieved after 6 weeks, and analyzed using histomorphometry. PL-supplemented cultures resulted in significantly larger colonies, shorter culture time period, and higher population doublings between P1 and P3 compared to FBS-containing cultures. No differences were observed in antigen expression profiles or differentiation capacities into the osteoblastic, chondrogenic, and adipogenic lineages, qualitatively. In vivo bone formation with PL-supplemented cultures of MSCs was demonstrated in 9/9 donors versus 6/9 for FBS-supplemented cultures. These results warrant the use of PL for ex vivo expansion of human MSCs for bone tissue engineering applications.

  8. Spectroscopic Study of the Interaction between Horse Heart Myoglobin and Zirconium(IV)-Substituted Polyoxometalates as Artificial Proteases.

    PubMed

    Ly, Hong Giang T; Parac-Vogt, Tatjana N

    2017-07-04

    A recent study [Angew. Chem. Int. Ed. 2015, 54, 7391-7394] has shown that horse heart myoglobin (HHM) is selectively hydrolyzed by a range of zirconium(IV)-substituted polyoxometalates (POMs) under mild conditions. In this study, the molecular interactions between the Zr-POM catalysts and HHM are investigated by using a range of complementary techniques, including circular dichroism (CD), UV/Vis spectroscopy, tryptophan fluorescence spectroscopy, and (1) H and (31) P NMR spectroscopy. A tryptophan fluorescence quenching study reveals that, among all examined Zr-POMs, the most reactive POM, 2:2 Zr(IV) -Keggin, exhibits the strongest interaction with HHM. (31) P NMR spectroscopy studies show that this POM dissociates in solution, resulting in the formation of a monomeric 1:1 Zr(IV) -Keggin structure, which is likely to be a catalytically active species. In the presence of Zr(IV) -POMs, HHM does not undergo complete denaturation, as evidenced by CD, UV/Vis, tryptophan fluorescence, and (1) H NMR spectroscopy. CD spectroscopy shows a gradual decrease in the α-helical content of HHM upon addition of Zr(IV) -POMs. The largest effect is observed in the presence of a large Zr(IV) -Wells-Dawson structure, whereas small Zr(IV) -Lindqvist POM has the least influence on the decrease in the α-helical content of HHM. In all cases, the Soret band at λ=409 nm is maintained in the presence of all examined Zr-POMs, which indicates that no conformational changes in the protein occur near the heme group. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. The use of a dermal substitute to preserve maximal foot length in diabetic foot wounds with tendon and bone exposure following urgent surgical debridement for acute infection.

    PubMed

    Clerici, Giacomo; Caminiti, Maurizio; Curci, Vincenzo; Quarantiello, Antonella; Faglia, Ezio

    2010-06-01

    In this study, we evaluated the utility of a dermal substitute for preserving maximal foot length after urgent surgical debridement. Patients referred to our Diabetic Foot Center with foot lesions were assessed for sensory-motor neuropathy, infection and critical limb ischaemia. The presence of acute foot infection indicated the need for immediate surgical debridement. The degree of amputation, if necessary, was based on the amount of apparently non infected vital tissue. When vital tendon/bone tissue remained exposed, the lesion was covered with a dermal substitute. From January to December 2008, 393 patients underwent surgical treatment for diabetic foot syndrome; 30 patients underwent immediate surgical debridement resulting in exposed tendon and/or bone tissues. An average of 4.4 +/- 2.1 days following surgical debridement, all 30 patients underwent dermal regeneration template grafting to cover-exposed healthy tendon and bone tissues, instead of achieving primary wound closure with a proximal amputation. After 21 days, a skin graft was performed. Complete wound healing occurred in 26 patients (86.7%). In these patients, the amputation level was significantly more distal (P < 0.003) with respect to that potentially required for immediate wound closure. The average healing time was 74.1 +/- 28.9 days. Four patients underwent a more proximal amputation. No patients underwent major amputation. The use of the dermal substitute for treating exposed tendon and bone tissues allowed timely wound healing and preserved maximal foot length. Continued follow-up will allow assessment of long-term relapse and complication rates. Such treatment could constitute part of the comprehensive management of diabetic wounds.

  10. Microwave sintering and in vitro study of defect-free stable porous multilayered HAp-ZrO2 artificial bone scaffold

    NASA Astrophysics Data System (ADS)

    Jang, Dong-Woo; Nguyen, Thi-Hiep; Sarkar, Swapan Kumar; Lee, Byong-Taek

    2012-06-01

    Continuously porous hydroxyapatite (HAp)/t-ZrO2 composites containing concentric laminated frames and microchanneled bodies were fabricated by an extrusion process. To investigate the mechanical properties of HAp/t-ZrO2 composites, the porous composites were sintered at different temperatures using a microwave furnace. The microstructure was designed to imitate that of natural bone, particularly small bone, with both cortical and spongy bone sections. Each microchannel was separated by alternating lamina of HAp, HAp-(t-ZrO2) and t-ZrO2. HAp and ZrO2 phases existed on the surface of the microchannel and the core zone to increase the biocompatibility and mechanical properties of the HAp-ZrO2 artificial bone. The sintering behavior was evaluated and the optimum sintering temperature was found to be 1400 °C, which produced a stable scaffold. The material characteristics, such as the microstructure, crystal structure and compressive strength, were evaluated in detail for different sintering temperatures. A detailed in vitro study was carried out using MTT assay, western blot analysis, gene expression by polymerase chain reaction and laser confocal image analysis of cell proliferation. The results confirmed that HAp-ZrO2 performs as an artificial bone, showing excellent cell growth, attachment and proliferation behavior using osteoblast-like MG63 cells.

  11. Strontium- and cobalt-substituted bioactive glasses seeded with human umbilical cord perivascular cells to promote bone regeneration via enhanced osteogenic and angiogenic activities.

    PubMed

    Kargozar, Saeid; Lotfibakhshaiesh, Nasrin; Ai, Jafar; Mozafari, Masoud; Brouki Milan, Peiman; Hamzehlou, Sepideh; Barati, Mahmood; Baino, Francesco; Hill, Robert G; Joghataei, Mohammad Taghi

    2017-08-01

    Designing and developing new biomaterials to accelerate bone healing are currently under progress. In this study, we attempted to promote osteogenesis using strontium- and cobalt-substituted bioactive glasses (BGs) seeded with human umbilical cord perivascular cells (HUCPVCs) in a critical size defect in the distal femur of rabbit animal model. The BG particles were successfully synthesized in the form of granules using the melt-derived route. After being isolated, HUCPVCs were expanded and then characterized to use during in vitro and in vivo procedures. The in vitro effects of the synthesized glasses on the isolated HUCPVCs as well as on cell lines SaOS-2 (selected for screening the osteogenetic potential) and HUVEC (selected for screening the angiogenic potential) were assessed by analyzing cytotoxicity, cell attachment, bone-like nodule formation, and real time PCR. The results of in vitro tests indicated cytocompatibility of the synthesized BG particles. For in vivo study, the HUCPVCs-seeded BGs were implanted into the animal's body. Radiographic imaging, histology and immunohistology staining were performed on the harvested specimens at 4 and 12weeks post-surgery. The in vivo evaluation of the samples showed that all the cell/glass constructs accelerated bone healing process in comparison with blank controls. The best in vitro and in vivo results were associated to the BGs containing both strontium and cobalt ions. This group of bioactive glasses is able to promote both osteogenesis and angiogenesis and can therefore be highly suitable for the development of advanced functional bone substitutes. Bone regeneration is considered as an unmet clinical need. The most recent researches focused on incorporation of strontium (Sr(2+)) and cobalt (Co(2+)) ions into bioactive glasses structure. Strontium is an alkaline earth metal which is currently used in the treatment of osteoporosis. Also, cobalt is considered as another promising element in the bone regeneration

  12. Osteochondral repair using a scaffold-free tissue-engineered construct derived from synovial mesenchymal stem cells and a hydroxyapatite-based artificial bone.

    PubMed

    Shimomura, Kazunori; Moriguchi, Yu; Ando, Wataru; Nansai, Ryosuke; Fujie, Hiromichi; Hart, David A; Gobbi, Alberto; Kita, Keisuke; Horibe, Shuji; Shino, Konsei; Yoshikawa, Hideki; Nakamura, Norimasa

    2014-09-01

    For an ideal osteochondral repair, it is important to facilitate zonal restoration of the subchondral bone and the cartilage, layer by layer. Specifically, restoration of the osteochondral junction and secure integration with adjacent cartilage could be considered key factors. The purpose of the present study was to investigate the feasibility of a combined material comprising a scaffold-free tissue-engineered construct (TEC) derived from synovial mesenchymal stem cells (MSCs) and a hydroxyapatite (HA) artificial bone using a rabbit osteochondral defect model. Osteochondral defects were created on the femoral groove of skeletally mature rabbits. The TEC and HA artificial bone were hybridized to develop a combined implant just before use, which was then implanted into defects (N=23). In the control group, HA alone was implanted (N=18). Histological evaluation and micro-indentation testing was performed for the evaluation of repair tissue. Normal knees were used as an additional control group for biomechanical testing (N=5). At hybridization, the TEC rapidly attached onto the surface of HA artificial bone block, which was implantable to osteochondral defects. Osteochondral defects treated with the combined implants exhibited more rapid subchondral bone repair coupled with the development of cartilaginous tissue with good tissue integration to the adjacent host cartilage when assessed at 6 months post implantation. Conversely, the control group exhibited delayed subchondral bone repair. In addition, the repair cartilaginous tissue in this group had poor integration to adjacent cartilage and contained clustered chondrocytes, suggesting an early osteoarthritis (OA)-like degenerative change at 6 months post implantation. Biomechanically, the osteochondral repair tissue treated with the combined implants at 6 months restored tissue stiffness, similar to normal osteochondral tissue. The combined implants significantly accelerated and improved osteochondral repair

  13. Antimicrobial Bone Graft Substitutes

    DTIC Science & Technology

    2004-09-01

    than similar injuries suffered by civilians. Standard care for open fractures requires multiple procedures, including irrigation , débridement...tibial tubercle. After elevating the periosteum with a periosteal elevator, a unicortical, 12-mm circular defect was produced with a coring reamer ...purulence; 2 for frank purulence at the wound site, or purulent discharge upon aspiration or incision and drainage. A score for each wound was calculated

  14. [Hydroxyapatite bone substitute (Ostim) in sinus floor elevation. Maxillary sinus floor augmentation: bone regeneration by means of a nanocrystalline in-phase hydroxyapatite (Ostim)].

    PubMed

    Smeets, Ralf; Grosjean, Maurice B; Jelitte, Gerd; Heiland, Max; Kasaj, Adrian; Riediger, Dieter; Yildirim, Murat; Spiekermann, Hubertus; Maciejewski, Oliver

    2008-01-01

    The range of bone regeneration materials suitable for maxillar bone augmentation has increased steadily in the past few years and there is now a wide variety of materials being used. In the present case report, we analyzed the state of bone regeneration after sinus floor augmentation using a nanocrystalline in-phase synthetic anorganic hydroxyapatite bone grafting material (Ostim). A 60-year-old female patient underwent maxillary sinus floor elevation and the cavity was filled with Ostim three years before. Actually, she presented herself with loosening of the dental implant at position 17, as a result of parafunction. At the time of the insertion of a second implant at position 17, bone samples were taken by using a trepan drilling device from the previously augmented area. These samples were analyzed histologically to determine the extent of bone remodeling around the deposits of Ostim. We found that the Ostim deposits were surrounded largely by woven bone and, in parts, by lamellar bone and had facilitated osteoconductive bone regeneration. The adjacent implant, at position 16, which beared a crown exposed to proper biting forces without parafunction, showed proper clinical and radiological characteristics of complete and firm integration into the area which was also filled with Ostim three years ago. We conclude that the use of the nanocrystalline hydroxyapatite Ostim with its stable volume properties appears to be suitable for maxillary sinus floor augmentation. Furthermore, we even found osteoconductive bone regeneration under Ostim near the site of the loosened implant.

  15. A novel method for segmenting and aligning the pre- and post-implantation scaffolds of resorbable calcium-phosphate bone substitutes.

    PubMed

    Sweedy, Ahmed; Bohner, Marc; van Lenthe, G Harry; Baroud, Gamal

    2017-03-02

    Micro-computed tomography (microCT) is commonly used to characterize the three-dimensional structure of bone graft scaffolds before and after implantation in order to assess changes occurring during implantation. The accurate processing of the microCT datasets of explanted β-tricalcium phosphate (β-TCP) scaffolds poses significant challenges because of (a) the overlap in the grey values distribution of ceramic remnants, bone, and soft tissue, and of (b) the resorption of the bone substitute during the implantation. To address those challenges, this article introduces and rigorously validates a new processing technique to accurately distinguish these three phases found in the explanted β-TCP scaffolds. Specifically, the microCT datasets obtained before and after implantation of β-TCP scaffolds were aligned in 3D, and the characteristic grey value distributions of the three phases were extracted, thus allowing for (i) the accurate differentiation between these three phases (ceramic remnants, bone, soft tissue), and additionally for (ii) the localization of the defect site in the post-implantation microCT dataset. Using the similarity matrix, a 94±1% agreement was found between algorithmic results and the visual assessment of 556,800 pixels. Moreover, the comparison of the segmentation results of the same microCT and histology section further confirmed the validity of the present segmentation algorithm. This new technique could lead to a more common use of microCT in analyzing the complex 3D processes and to a better understanding of the biological processes occurring after the implantation of ceramic bone graft substitutes.

  16. Comparison of three calcium phosphate bone graft substitutes from biomechanical, histological, and crystallographic perspectives using a rat posterolateral lumbar fusion model.

    PubMed

    Hu, Ming-Hsien; Lee, Pei-Yuan; Chen, Wen-Cheng; Hu, Jin-Jia

    2014-12-01

    This study evaluated the effectiveness of three calcium phosphate bone graft substitutes with different chemical compositions on spinal fusion using a rat posterolateral lumbar fusion model. Specifically, two recently developed non-dispersive tetracalcium phosphate/dicalcium phosphate anhydrous-based calcium phosphate cements (CPCs), namely a CPC consisting of equimolar amounts of the two compounds (nd-CPC) and a CPC consisting of a two-fold greater amount of dicalcium phosphate anhydrous (DCP-rich CPC), were compared with a commercial calcium phosphate bone graft (c-CPG) consisting of hydroxyapatite (60%) and β-tricalcium phosphate (40%). Single-level posterolateral lumbar fusion was performed at the L4-L5 vertebrae in fifteen adult rats (n=5 for each group). Spinal fusion was evaluated with radiographs, manual palpation, mechanical testing, micro-CT, and histology 8 weeks post-surgery. In particular, the crystallographic phases in the three substitutes were identified before and 8 weeks after their implantation. Manual palpation revealed stable constructs in nearly all of the spine specimens. The stiffness and bending load of fused spines in the two CPC groups were comparable to those in the c-CPG group. The radiographs specifically revealed implant resorption and bone remodeling in the DCP-rich CPC group. Analysis of 3D micro-CT images revealed that the bone volume ratio in the DCP-rich CPC group was significantly greater than those in the nd-CPC and c-CPG groups. Histology showed that the DCP-rich CPC group exhibited the highest degree of bone regeneration and osseointegration. Notably, DCP-rich CPC led to a pronounced phase transformation, generating the greatest amount of poorly crystalline apatite among the three groups, which together with adequate resorption may explain the aforementioned positive findings. We therefore conclude that of the bone graft substitutes considered, DCP-rich CPC has the greatest potential to be used in spinal fusion. Copyright

  17. An injectable bone substitute composed of beta-tricalcium phosphate granules, methylcellulose and hyaluronic acid inhibits connective tissue influx into its implantation bed in vivo.

    PubMed

    Ghanaati, S; Barbeck, M; Hilbig, U; Hoffmann, C; Unger, R E; Sader, R A; Peters, F; Kirkpatrick, C J

    2011-11-01

    In this study, the in vivo tissue reaction to a new triphasic and injectable paste-like bone-substitute material composed of beta-tricalcium phosphate (β-TCP), methylcellulose and hyaluronic acid was analyzed. Using a subcutaneous implantation model, the interaction of these materials and the peri-implant tissue reaction were tested in Wistar rats for up to 60 days by means of established histological methods, including histomorphometrical analysis. The study focused on tissue integration, classification of the cellular inflammatory response and the degradation of the material. Groups composed of animals injected only with β-TCP granules, sham-operated animals and animals injected with saline were used as controls. After implantation, the triphasic bone-substitute material was present as a bulk-like structure with an inner and outer core. Over a period of 60 days, the material underwent continuous degradation from the periphery towards the core. The implantation bed of the β-TCP granule control group was invaded by phagocytes and formed a poorly vascularized connective tissue soon after implantation. This inflammatory response continued throughout the study period and filled the implantation bed. Significantly, the combination of the three biocompatible materials into one injectable paste-like bone-substitute material enabled modification of the tissue reaction to the implant and resulted in a longer in vivo lifetime than that of β-TCP granules alone. In addition, this combination increased the vascularization of the implantation bed, which is essential for successful tissue regeneration. Copyright © 2011 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  18. Biological evaluation of alginate-based hydrogels, with antimicrobial features by Ce(III) incorporation, as vehicles for a bone substitute.

    PubMed

    Morais, D S; Rodrigues, M A; Lopes, M A; Coelho, M J; Maurício, A C; Gomes, R; Amorim, I; Ferraz, M P; Santos, J D; Botelho, C M

    2013-09-01

    A novel hydrogel, based on an alginate/hyaluronate mixture and Ce(III) ions, with effective bioactive and antimicrobial ability was developed to be used as vehicle of a synthetic bone substitute producing an injectable substitute (IBS). Firstly, three different IBSs were prepared using three developed alginate-based hydrogels, the hydrogel Alg composed by alginate, the hydrogel Alg/Ch composed by an alginate/chitosan mixture and the hydrogel Alg/HA composed by an alginate/hyaluronate mixture. MG63 cells viability on the IBSs was evaluated, being observed a significantly higher cell viability on the Alg/HA_IBS at all time points, which indicates a better cell adaptation to the material, increasing their predisposition to produce extracellular matrix and thus allowing a better bone regeneration. Moreover, SEM analysis showed evident filopodia and a spreader shape of MG63 cells when seeded on Alg/HA_IBS. This way, based upon the in vitro results, the hydrogel Alg/HA was chosen to the in vivo study by subcutaneous implantation in an animal model, promoting a slight irritating tissue response and visible tissue repairing. The next step was to grant antimicrobial properties to the hydrogel that showed the best biological behavior by incorporation of Ce(III) ions into the Alg/HA, producing the hydrogel Alg/HA2. The antimicrobial activity of these hyaluronate-based hydrogels was evaluated against Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa and Candida albicans. Results showed that Ce(III) ions can significantly enhance the hydrogel antimicrobial ability without compromising the osteoconductivity improvement promoted by the vehicle association to the synthetic bone substitute.

  19. [Preparation and ectopic osteoinduction study of macroporous bone substitute with calcium phosphate cements and rhBMP-2 loaded gelatin microspheres].

    PubMed

    Li, Meng; Liu, Xu-dong; Liu, Xing-yan; Ge, Bao-feng

    2011-05-01

    To prepare macroporous bone substitute composed of calcium phosphate cements and rhBMP-2 loaded gelatin microspheres, and to investigate ectopic osteoinduction of the composite. After being prepared by improved emulsified cold-condensation method and crosslinked by 5% genipin solution,gelatin microspheres (GMs) were observed by scanning electron microscope (SEM) and loaded with rhBMP-2 by adsorption. Macroporous bone substitute was developed by mixing calcium phosphate cement (CPC) with 2.5% GMs, being as the experimental group,and CPC with rhBMP-2 was the control group. After the both composites had been soaked in the sodium chloride for 1 week or 3 weeks, compressive strength of the composites were tested, and the cross-sections were observed by SEM. Concentrations of rhBMP-2 in the solutions at different time by ELISA method and the cumulative drug release amount was calculated. The composites had been implanted in the muscle bags of the mouses for 3 weeks. Then the tissues around the materials were collected, stained by hematoxylin and eosin, and Ca and ALP in the tissues were also measured. Gelatin microspheres were spherical with diameters of (62 +/- 18) microm. Macropores appeared in the experimental materials 1 week and 3 weeks after being soaked,and total porosity, macroporosity, cumulative release amount of rhBMP-2 in the experimental group were higher than that in the control. But compressive strength of the experimental group was lower than that of the control group 3 weeks after being soaked. Results of HE stain showed chondral formation in both groups, but there were more chondral tissues in the experiment group, and so were the concentrations of Ca and ALP. Macroporous calcium phosphate cement can be prepared by using rhBMP-2 loaded gelatin microspheres, and it is an excellent bone substitute due to it's proterty of promoting rhBMP release and powerful ectopic osteoinduction.

  20. Effects of increased collagen-matrix density on the mechanical properties and in vivo absorbability of hydroxyapatite-collagen composites as artificial bone materials.

    PubMed

    Yunoki, Shunji; Sugiura, Hiroaki; Ikoma, Toshiyuki; Kondo, Eiji; Yasuda, Kazunori; Tanaka, Junzo

    2011-02-01

    The aim of this study was to evaluate the effects of increased collagen-matrix density on the mechanical properties and in vivo absorbability of porous hydroxyapatite (HAp)-collagen composites as artificial bone materials. Seven types of porous HAp-collagen composites were prepared from HAp nanocrystals and dense collagen fibrils. Their densities and HAp/collagen weight ratios ranged from 122 to 331 mg cm⁻³ and from 20/80 to 80/20, respectively. The flexural modulus and strength increased with an increase in density, reaching 2.46 ± 0.48 and 0.651 ± 0.103 MPa, respectively. The porous composites with a higher collagen-matrix density exhibited much higher mechanical properties at the same densities, suggesting that increasing the collagen-matrix density is an effective way of improving the mechanical properties. It was also suggested that other structural factors in addition to collagen-matrix density are required to achieve bone-like mechanical properties. The in vivo absorbability of the composites was investigated in bone defects of rabbit femurs, demonstrating that the absorption rate decreased with increases in the composite density. An exhaustive increase in density is probably limited by decreases in absorbability as artificial bones.

  1. The effect of polystyrene sodium sulfonate grafting on polyethylene terephthalate artificial ligaments on in vitro mineralisation and in vivo bone tissue integration

    PubMed Central

    Vaquette, Cédryck; Viateau, Véronique; Guérard, Sandra; Anagnostou, Fani; Manassero, Mathieu; Castner, David G.; Migonney, Véronique

    2013-01-01

    This study investigates the impact of polystyrene sodium sulfonate (PolyNaSS) grafting onto the osseointegration of a polyethylene terephthalate artificial ligament (Ligament Advanced Reinforcement System, LARS™) used for Anterior Cruciate Ligament (ACL). The performance of grafted and non-grafted ligaments was assessed in vitro by culturing human osteoblasts under osteogenic induction and this demonstrated that the surface modification was capable of up-regulating the secretion of ALP and induced higher level of mineralisation as measured 6 weeks post-seeding by Micro-Computed Tomography. Grafted and non-grafted LARS™ were subsequently implanted in an ovine model for ACL reconstruction and the ligament-to-bone interface was evaluated by histology and biomechanical testing 3 and 12 months post-implantation. The grafted ligaments exhibited more frequent direct ligament-to-bone contact and bone formation in the core of the ligament at the later time point than the nongrafted specimens, the grafting also significantly reduced the fibrous encapsulation of the ligament 12 months post-implantation. However, this improved osseo-integration was not translated into a significant increase in the biomechanical pull-out loads. These results provide evidences that PolyNaSS grafting improved the osseo-integration of the artificial ligament within the bone tunnels. This might positively influence the outcome of the surgical reconstructions, as higher ligament stability is believed to limit micro-movement and therefore permits earlier and enhanced healing. PMID:23790438

  2. Effect of a carbonated HAP/β-glucan composite bone substitute on healing of drilled bone voids in the proximal tibial metaphysis of rabbits.

    PubMed

    Borkowski, Leszek; Pawłowska, Marta; Radzki, Radosław P; Bieńko, Marek; Polkowska, Izabela; Belcarz, Anna; Karpiński, Mirosław; Słowik, Tymoteusz; Matuszewski, Łukasz; Ślósarczyk, Anna; Ginalska, Grażyna

    2015-08-01

    A novel elastic hydroxyapatite-based composite of high surgical handiness has been developed. Its potential application in orthopedics as a filler of bone defects has been studied. The biomaterial was composed of carbonated hydroxyapatite (CHAP) granules and polysaccharide polymer (β-1,3-glucan). Cylinders of 4mm in diameter and 6mm in length were implanted into bone cavities created in the proximal metaphysis of tibiae of 24 New Zealand white rabbits. 18 sham-operated animals were used as controls. After 1, 3 or 6 months, the rabbits were euthanized, the bones were harvested and subjected to analysis. Radiological images and histological sections revealed integration of implants with bone tissue with no signs of graft rejection. Peripheral quantitative computed tomography (pQCT) indicated the stimulating effect of the biomaterial on bone formation and mineralization. Densitometry (DXA) analysis suggested that biomineralization of bones was preceded by bioresorption and gradual disappearance of porous ceramic granules. The findings suggest that the CHAP-glucan composite material enables regeneration of bone tissue and could serve as a bone defect filler. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Management of an endo perio lesion in a maxillary canine using platelet-rich plasma concentrate and an alloplastic bone substitute

    PubMed Central

    Singh, Sangeeta

    2009-01-01

    To evaluate the efficacy of platelet-rich plasma concentrate in the management of a cirumferential, infrabony defect associated with an endoperio lesion in a maxillary canine. A 45 year-old male patient with an endoperio lesion in the left maxillary canine was initially treated with endodontic therapy. Following the endodontic treatment, the circumferential, infrabony defect was treated using platelet-rich plasma and an alloplastic bone substitute. At the end of three months, there was a gain in the clinical attachment level and reduction in probing depth. Radiographic evidence showed that there was significant bony fill. The results were maintained at the time of recall nine months later. PMID:20407658

  4. Bone

    NASA Astrophysics Data System (ADS)

    Helmberger, Thomas K.; Hoffmann, Ralf-Thorsten

    The typical clinical signs in bone tumours are pain, destruction and destabilization, immobilization, neurologic deficits, and finally functional impairment. Primary malignant bone tumours are a rare entity, accounting for about 0.2% of all malignancies. Also benign primary bone tumours are in total rare and mostly asymptomatic. The most common symptomatic benign bone tumour is osteoid osteoma with an incidence of 1:2000.

  5. Fabrication and evaluation of a new composite composed of tricalcium phosphate, gelatin, and Chinese medicine as a bone substitute.

    PubMed

    Yao, Chun-Hsu; Tsai, Hung-Ming; Chen, Yueh-Sheng; Liu, Bai-Shuan

    2005-11-01

    This study investigates the biological effects of traditional Chinese medicines on the activities of bone cells using rat bone cells. Then, a mixture of a GGT composite, that is, a novel biodegradable composite containing genipin crosslinked gelatin and tricalcium phosphate, and traditional Chinese medicine (TCM) was prepared as a GGT-TCM composite. A cultured neonatal rat calvarias organ was used to measure the potential of GGT-TCM composite for use in promoting the regeneration of defective bone tissue. The mitochondria activity of the bone cells following exposure to various concentrations of crude extracts of five herbal Chinese medicines was measured by colorimetric assay. Biochemical markers, such as alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP) titers were analyzed to evaluate the activities of bone cells. Finally, we examined the organ culture units, which were maintained in cultured medium for 5 weeks. Morphology of tissue was observed, and the quantitative evaluation of the regenerated bone was determined. In a bone cells culture experiment, adding Cuscuta chinensis Lam. (TCM-5) to the bone cells culture clearly promoted the proliferation and differentiation of the osteoblasts from their precursor cells; but the reduced amount of TRAP indicated that the medicine significantly inhibited the osteoclasts activities. Opposite bone cell responses were observed when Loranthus parasiticus Merr. (TCM-3) and Achyranthes bidentata Bl. (TCM-4) were added to the bone cells culture. Eucommia ulmoides Oliv. (TCM-1) and Dipsacus asper Wall. (TCM-2) potentially influence the proliferation and differentiation of the osteoblasts from their precursor cells, but they did not affect the osteoclasts activities. The finding from the organ culture indicated that Chinese medicine effectively increased the rate of tissue regeneration of damaged bones.

  6. Improvement of the maxillary bone growth suppression in the cleft palate operation with cultured dermal substitute: animal experiment and patient reports in preliminary clinical application.

    PubMed

    Kurokawa, N; Ueda, K; Kuroyanagi, Y

    2010-03-01

    Cleft palate patients often show impaired maxillary bone growth after cleft-palate-correction surgery. We attempted to investigate and elucidate the effects of using allogeneic, cultured dermal substitute (CDS) to cover an exposed, palatal bone surface in animal experiments. Fibroblasts from the abdominal skin of Wistar rats were cultured. Subsequently, the fibroblasts were seeded onto a matrix that composed of hyaluronic acid and atelo-collagen. Forty Wistar rats (3-week-old males) were assigned to one of four groups: control, open-treatment, matrix and CDS groups. The control group (n=5) received no surgical operations. In the open-treatment group (n=11), the mucosa and periosteum of the left-half of the palate were removed surgically and the bone was exposed. In the matrix group (n=11), the area of exposed bone was covered with only the matrix, excluding any cells. In the CDS group (n=10), the area of exposed bone was covered with CDS. At 9 weeks postoperatively, biopsies of the wounds were obtained. Skull preparations were made and the palatal widths were determined. The palatal widths in the CDS group were significantly wider compared to the matrix and open-treatment groups (P<0.05). However, there were no significant differences when the CDS group was compared to the control group. Haematoxylin, eosin and CD31 immunostaining confirmed a larger number of capillaries in the CDS group. This animal experiment suggested that this procedure might provide an optimum wound-healing condition, thus, reducing the maxillary bone-growth suppression. Therefore, a preliminary clinical application in three patients was performed using the autologous CDS after the pushback method. (c) 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Immunoexpression of Cbfa-1/Runx2 and VEGF in sinus lift procedures using bone substitutes in rabbits.

    PubMed

    De Souza Nunes, Leandro Soeiro; De Oliveira, Renato Victor; Holgado, Leandro Andrade; Nary Filho, Hugo; Ribeiro, Daniel Araki; Matsumoto, Mariza Akemi

    2010-06-01

    To analyze and compare the expression of core binding factor-1 (Cbfa-1)/Runx2 and vascular endothelium growth factor (VEGF) in sinus lift procedures using bovine hydroxyapatite (HA) and beta-tricalcium phosphate (beta-TCP). Twenty-four male rabbits that had undergone bilateral sinus lift procedures were divided into three groups, according to the sinus filling material: Group 1: autogenous bone graft; Group 2: bovine HA; and Group 3: beta-TCP. All groups were sacrificed after 7, 14, 30 and 60 days, for microscopic, histomorphometry and immunohistochemistry analysis. Microscopic analysis showed a similar bone repair pattern between the tested groups. New bone formation, soft and medular tissue, remaining material or particulate bone graft area were obtained by histomorphometric analysis. After 14 days, statistically significant differences in new bone formation were found between Group 1 (27.76+/-7.8) and Groups 2 (14.22+/-3.2) and 3 (11.1+/-7.7). After 30 days, statistically significant differences (P<0.05) were detected in bone formation between Groups 1 (31.39+/-36.5) and 2 (14.13+/-3.2). The last period showed improved bone formation in Group 2. Also, Group 2 showed higher Cbfa-1/Runx2 immunoexpression when compared with Group 3. No remarkable differences were observed in VEGF immunoexpression among groups. Taken together, both biomaterials allowed bone tissue growth in a conductive pattern and did not interfere with bone remodeling in the late period, with a slight improvement in bone tissue formation when using HA, confirmed by marked expression of Cbfa-1 at initial periods.

  8. Healing of onlay mandibular bone grafts covered with collagen membrane or bovine bone substitutes: a microscopical and immunohistochemical study in the sheep.

    PubMed

    Adeyemo, W L; Reuther, T; Bloch, W; Korkmaz, Y; Fischer, J H; Zöller, J E; Kuebler, A C

    2008-07-01

    The objective of this study was to evaluate the role of collagen membrane and Bio-Oss coverage in healing of an onlay graft to the mandible. Twelve adult sheep each received an onlay bone graft (experiment 1), bone graft+Bio-Gide (experiment 2), and bone graft+Bio-Oss/Bio-Gide (experiment 3) on the lateral surface of the mandible. The animals were euthanized at 4, 8, 12 or 16 weeks after surgery, and findings were analysed by routine microscopy and immunohistochemistry for proliferation (Ki67) and apoptotic (Caspase-3) markers. Grafts were fully incorporated in all specimens. Pronounced resorption was observed in experiment 1. Minimal loss of graft volume was seen in experiment 2 specimens without membrane displacement. A remarkable increase in the augmented region of the mandible was observed in experiment 3. A high number of osteoclasts were expressed within the grafts during the early healing period, and thereafter declined markedly. Osteoblasts within the grafts expressed a moderate level of Ki67 at 8 weeks, which thereafter declined markedly. The strongest expression of Caspase-3 on the bone surface was observed after 16 weeks. In conclusion, the effect of collagen membrane coverage on bone graft volume maintenance was dependent on membrane stability during healing. An autogenous bone graft covered with Bio-Oss particles resulted in a remarkable increase in augmented lateral surface of the mandible. The late stage of bone graft healing was associated with a high apoptotic induction pathway of osteoblasts lining the surfaces of the new bone, demonstrated by strong positive Caspase-3 immunoreactivity.

  9. Behavior of POP-calcium carbonate hydrogel as bone substitute with controlled release capability: a study in rat.

    PubMed

    Dewi, Anne Handrini; Ana, Ika Dewi; Wolke, Joop; Jansen, John

    2015-10-01

    Gypsum or calcium sulfate (CS) or plaster of Paris (POP) is considered as a fast degradable material that usually resorbs before the bone defect area is completely filled by new bone. In this study, the incorporation of CaCO3 hydrogel into POP in different compositions was proposed to enhance the bone biological activity of POP and to decrease its degradability. The mechanical and degradation properties of the various materials were characterized by in vitro analysis. Subsequently, the materials were inserted into cylindrically sized bone defects as created into the femoral condyle of rats and left in situ for 1, 4, and 8 weeks. Histological analysis of the retrieved specimens indicated that the addition of CaCO3 hydrogel into POP increased bone formation, angiogenesis and collagen density and resulted into faster bone formation and maturation. It was also confirmed that the degradation rate of the POP decreased by the addition of CaCO3 hydrogel. The in vivo findings did corroborate with the in vitro analysis. In conclusion, the incorporation of CaCO3 hydrogel provides a promising technology to improve the properties of POP, the oldest biomaterial used for bone grafting. © 2015 Wiley Periodicals, Inc.

  10. Evaluation of bone substitute materials: comparison of flat-panel based volume CT to conventional multidetector CT.

    PubMed

    Sauerbier, Sebastian; Duttenhoefer, Fabian; Sachlos, Elefterios; Haberstroh, Jörg; Scheifele, Christian; Wrbas, Karl-Thomas; Voss, Pit Jacob; Veigel, Egle; Smedek, Jörg; Ganter, Philip; Tuna, Taskin; Gutwald, Ralf; Palmowski, Moritz

    2013-10-01

    Over the last decade tissue engineering has emerged as a key factor in bone regeneration within the field of cranio-maxillofacial surgery. Despite this in vivo analysis of tissue-engineered-constructs to monitor bone rehabilitation are difficult to conduct. Novel high-resolving flat-panel based volume CTs (fp-VCT) are increasingly used for imaging bone structures. This study compares the potential value of novel fp-VCT with conventional multidetector CT (MDCT) based on a sheep sinus floor elevation model. Calcium-hydroxyapatite reinforced collagen scaffolds were populated with autologous osteoblasts and implanted into sheep maxillary sinus. After 8, 16 and 24 weeks MDCT and fp-VCT scans were performed to investigate the volume of the augmented area; densities of cancellous and compact bone were assessed as comparative values. fp-VCT imaging resulted in higher spatial resolution, which was advantageous when separating closely related anatomical structures (i.e. trabecular and compact bone, biomaterials). Fp-VCT facilitated imaging of alterations occurring in test specimens over time. fp-VCTs therefore displayed high volume coverage, dynamic imaging potential and superior performance when investigating superfine bone structures and bone remodelling of biomaterials. Thus, fp-VCTs may be a suitable instrument for intraoperative imaging and future in vivo tissue-engineering studies.

  11. Applicability of cranial models in urethane resin and foam as a substitute for bone: are synthetic materials reliable?

    PubMed

    Muccino, Enrico; Porta, Davide; Magli, Francesca; Cigada, Alfredo; Sala, Remo; Gibelli, Daniele; Cattaneo, Cristina

    2013-09-01

    As literature is poor in functional synthetic cranial models, in this study, synthetic handmade models of cranial vaults were produced in two different materials (a urethane resin and a self-hardening foam), from multiple bone specimens (eight original cranial vaults: four human and four swine), in order to test their resemblance to bone structure in behavior, during fracture formation. All the vaults were mechanically tested with a 2-kg impact weight and filmed with a high-speed camera. Fracture patterns were homogeneous in all swine vaults and heterogeneous in human vaults, with resin fractures more similar to bone fractures. Mean fracture latency time extrapolated by videos were of 0.75 msec (bone), 1.5 msec (resin), 5.12 msec (foam) for human vaults and of 0.625 msec (bone), 1.87 msec (resin), 3.75 msec (foam) for swine vaults. These data showed that resin models are more similar to bone than foam reproductions, but that synthetic material may behave quite differently from bone as concerns fracture latency times.

  12. Complex reconstruction of the dorsal hand using the induced membrane technique associated with bone substitute: A case report

    PubMed Central

    Guillier, David; Rizzi, Philippe; De Taddeo, Alice; Henault, Benoit; Tchurukdichian, Alain; Zwetyenga, Narcisse

    2016-01-01

    Introduction High-energy trauma of the hand often causes tissue loss involving bone, tendon and skin and is sometimes accompanied by devascularization of digits. Bone stabilization is the first step in the management of such injuries. Materials and methods A young patient presented composite tissue loss of the dorsum of his right (dominant) hand following an accident with a surface planer. Tissue loss involved the diaphyses of the first 4 metacarpals, tendons and skin with almost complete amputation of the 3rd finger. Bone stabilization comprised osteosynthesis using pins associated with cement to fill the bone defect. Hunter tendon rods were used for tendon repair and a pedicle groin flap (McGregor) was used to achieve skin coverage. The cement was replaced with autologous cortico-cancellous bone graft combined with bone paste (Nanostim) 3 months after the cement stabilization. Results Eleven months after the accident, the patient was able to return to work as a carpenter. Pinch and Grasp strength in the injured hand were half that in the contralateral hand, but there was no loss of sensitivity. Mobility was very satisfactory with a Kapandji score of 9 and a mean TAM of 280°. The patient can write, open a bottle and does not feel limited for everyday activities. Radiographically, the bone of the 3 reconstructed metacarpals appears consolidated. Conclusion The induced membrane technique allowed the reconstruction of small bone deficits in the long bones of the hand in a two-step procedure, the first step taking place in an emergency context of composite tissue trauma. PMID:27077131

  13. Manufacture and cytotoxicity of a lead-free piezoelectric ceramic as a bone substitute-consolidation of porous lithium sodium potassium niobate by cold isostatic pressing.

    PubMed

    Wang, Qi; Yang, Jun; Zhang, Wu; Khoie, Roxanne; Li, Yi-Ming; Zhu, Jian-Guo; Chen, Zhi-Qing

    2009-06-01

    The piezoelectric properties and cytotoxicity of a porous lead-free piezoelectric ceramic for use as a direct bone substitute were investigated. Cold isostatic pressing (CIP) was applied to fabricate porous lithium sodium potassium niobate (Li0.06Na0.5K0.44) NbO3 specimens using a pore-forming method. The morphologies of the CIP-processed specimens were characterized and compared to those of specimens made by from conventional pressing procedures. The effects of the ceramic on the attachment and proliferation of osteoblasts isolated from the cranium of 1-day-old Sprague-Dawley rats were examined by a scanning electron microscopy (SEM) and methylthiazol tetrazolium (MTT) assay. The results showed that CIP enhanced piezoelectricity and biological performance of the niobate specimen, and also promoted an extracellular matrix-like topography of it. In vitro studies showed that the CIP-enhanced material had positive effects on the attachment and proliferation of osteoblasts. Niobate ceramic generated by CIP shows a promise for being a piezoelectric composite bone substitute.

  14. Bioimaging assessment and effect of skin wound healing using bone-marrow-derived mesenchymal stromal cells with the artificial dermis in diabetic rats.

    PubMed

    Inoue, Hirokazu; Murakami, Takashi; Ajiki, Takashi; Hara, Mayumi; Hoshino, Yuichi; Kobayashi, Eiji

    2008-01-01

    We investigate the relationship between the fate and healing effect of transplanted mesenchymal stromal cells (MSCs) in a rat diabetic skin wound model. Rats are treated with streptozotocin to induce diabetic conditions. A full-thickness skin defect is surgically made on the head of diabetic rats, and covered with an artificial dermis impregnated with either bone marrow cells (BMCs) or bone-marrow-derived MSCs from firefly luciferase (luc) transgenic (Tg) rats. Wound healing is evaluated using planimetry and immunohistochemistry, and the fate of transplanted MSCs is determined using in-vivo luminescent imaging. The diabetic wound treated with MSCs-impregnated artificial dermis is significantly smaller than that treated with artificial dermis alone at 1 week postoperation. Photons of luc+ MSCs are detected at the transplanted site during healing (3 weeks), whereas those of luc+ MSCs are depleted only after 1 week postimplantation. Immunohistochemistry at the healing site treated with MSCs demonstrates that CD31+ vessels increase with expression of vascular endothelial growth factor, suggesting that MSCs accelerate angiogenesis. These findings suggest that transplanted MSCs could be retained at wound sites during the healing process in a diabetic rat model, and subsequently promote wound healing through angiogenesis.

  15. The effectiveness of a resorbable bone substitute with a resorbable membrane in the treatment of periodontal infrabony defect - A multicenter randomised controlled trial.

    PubMed

    Esposito, Marco; Grusovin, Maria Gabriella; Lambert, France; Matos, Sérgio; Pietruska, Małgorzata; Rossi, Roberto; Salhi, Leila; Buti, Jacopo

    2015-01-01

    To evaluate the effectiveness of a bone substitute covered with a resorbable membrane versus open flap debridement for the treatment of periodontal infrabony defects. Ninety-seven patients with one infrabony defect, which was 3 mm or deeper and at least 2 mm wide were randomly allocated either to grafting with a bone substitute covered with a resorbable barrier (BG group) or open flap debridement (OFD group) according to a parallel group design in five European centres. Blinded outcome measures assessed tooth loss, complications, patient's satisfaction with treatment and aesthetics, changes in probing attachment levels (PAL), probing pocket depths (PPD), gingival recessions (REC), radiographic bone levels (RAD) on standardised periapical radiographs, plaque index (PI) and marginal bleeding index (MBI). 49 patients were randomly allocated to the BG group and 48 to the OFD group. At baseline there were more mobile teeth in the BG group (29 versus 15). One year after treatment two patients dropped out from the BG group and no teeth were lost. Three complications (minor postoperative wound dehiscence) occurred in the BG group versus none in the OFD group, where the difference was not statistically significant. The BG group obtained significantly greater statistical PAL gain (mean difference = -0.8 mm, 95% CI [-1.51; -0.03], P = 0.0428), PPD reduction (mean difference = -1.1 mm, 95% CI [-1.84; -0.19], P = 0.0165) and RAD gain (mean difference = -1.2 mm, 95% CI [-2.0; -0.4], P = 0.0058) compared to the OFD group. No statistically significant differences between the groups were observed for gingival recession, or the patient's satisfaction with the treatment and aesthetics. There were some statistically significant differences between the centres for PAL and PPD with the Italian centres reporting better outcomes. The use of a bone substitute covered with a resorbable membrane yielded significantly better statistical clinical outcomes than open flap debridement in the

  16. A new surgical management for oro-antral communication: the resorbable guided tissue regeneration membrane--bone substitute sandwich technique.

    PubMed

    Ogunsalu, C

    2005-09-01

    This paper describes a new technique for the closure of oro-antral fistula/communication, in which both hard tissue (bone) and soft tissue closure is achieved. The sandwich technique utilizes a suitable bone grafting material sandwiched between two sheaths of Biogide (a resorbable membrane) for the hard tissue closure of oro-antral communication post traumatic exodontia. The bone grafting material utilized for this case was Bio-oss. The result obtained was excellent with regeneration of sufficient bony tissue to allow placement of an endosseous implant. This sandwich technique is a simple and excellent technique for the closure of oro-antral communication, especially when subsequent placement of endosseous implant is considered without the need of donor site surgery for bone grafting. The otorhinolaryngologists and oral and maxillofacial surgeons should find this technique very useful in the closure of oro-antral fistulae.

  17. Comparison of cell viability and morphology of a human osteoblast-like cell line (SaOS-2) seeded on various bone substitute materials: An in vitro study.

    PubMed

    Ayobian-Markazi, Nader; Fourootan, T; Kharazifar, M J

    2012-01-01

    Many studies have shown favorable results following the use of different bone graft materials. The aim of the present study was to evaluate the biocompatibility of four different bone graft materials regarding cell viability and morphology of Human osteoblast-like cells (SaOS-2) in vitro. The effects of Bio-Oss(®), Tutodent(®), Osteon(®), and Cerasorb(®) were studied on the human osteoblast-like cell line to evaluate various parameters. Human osteoblast-like cells were seeded onto the mentioned bone substitute materials (BSMs). Cell differentiation; cell viability and alkaline phosphatase (ALP) activity of the seeded cells were evaluated by means of scanning electron microscopy, cell viability test and phase contrast microscopy Analysis of variance (ANOVA). Tamhane's post-hoc, Kruskal-Wallis Test, and Dunn's Test were used. The results were considered to be statistically significant at P<0.05. The control group (SaOS-2 cells which were incubated in Dulbecco Modified Eagle Medium without any kind of bone graft materials) had the highest level of cell viability (P<0.001), followed by Tutodent(®), Osteon(®), Cerasorb(®), and Bio-Oss(®). There was no significant difference in MTT assay results between Tutodent(®) and the control group (P=0.032). All tested bone graft materials showed significantly higher ALP activity than the control (P<0.001). The Tutodent(®) group showed the best cell growth among all experimental groups, followed by the Osteon(®) group. The former had a higher spindle-like morphology with good attachment to the surface. Cells cultivated on the surfaces of the Cerasorb(®) and Bio-Oss(®) granules had more round morphologies. This in vitro study demonstrated that all tested BSMs can provide good cell differentiation but a lower rate of proliferation.

  18. Comparison of cell viability and morphology of a human osteoblast-like cell line (SaOS-2) seeded on various bone substitute materials: An in vitro study

    PubMed Central

    Ayobian-Markazi, Nader; Fourootan, T.; Kharazifar, M. J.

    2012-01-01

    Background: Many studies have shown favorable results following the use of different bone graft materials. The aim of the present study was to evaluate the biocompatibility of four different bone graft materials regarding cell viability and morphology of Human osteoblast-like cells (SaOS-2) in vitro. Materials and Methods: The effects of Bio-Oss®, Tutodent®, Osteon®, and Cerasorb® were studied on the human osteoblast-like cell line to evaluate various parameters. Human osteoblast-like cells were seeded onto the mentioned bone substitute materials (BSMs). Cell differentiation; cell viability and alkaline phosphatase (ALP) activity of the seeded cells were evaluated by means of scanning electron microscopy, cell viability test and phase contrast microscopy Analysis of variance (ANOVA). Tamhane's post-hoc, Kruskal-Wallis Test, and Dunn's Test were used. The results were considered to be statistically significant at P<0.05. Results: The control group (SaOS-2 cells which were incubated in Dulbecco Modified Eagle Medium without any kind of bone graft materials) had the highest level of cell viability (P<0.001), followed by Tutodent®, Osteon®, Cerasorb®, and Bio-Oss®. There was no significant difference in MTT assay results between Tutodent® and the control group (P=0.032). All tested bone graft materials showed significantly higher ALP activity than the control (P<0.001). The Tutodent® group showed the best cell growth among all experimental groups, followed by the Osteon® group. The former had a higher spindle-like morphology with good attachment to the surface. Cells cultivated on the surfaces of the Cerasorb® and Bio-Oss® granules had more round morphologies. Conclusion: This in vitro study demonstrated that all tested BSMs can provide good cell differentiation but a lower rate of proliferation. PMID:22363369

  19. Fusion rate and clinical outcome in anterior lumbar interbody fusion with beta-tricalcium phosphate and bone marrow aspirate as a bone graft substitute. A prospective clinical study in fifty patients.

    PubMed

    Lechner, Ricarda; Putzer, David; Liebensteiner, Michael; Bach, Christian; Thaler, Martin

    2017-02-01

    Bone graft substitutes have been successfully used in posterolateral lumbar fusion, anterior cervical fusion and animal studies. This study has been conducted to assess the safety and efficacy of β-tricalcium phosphate (β-TCP) in instrumented anterior lumbar interbody fusion (ALIF) procedure. In a prospective clinical study, ALIF cages were prefilled with β-TCP and additionally fixated with posterior pedicle screw. Computed tomography (CT) and X-rays were performed one year after surgery. Fusion was assessed and functional status was evaluated before and one year after surgery. X-ray evaluation showed a definite fusion in 85.48 % of treated levels. CT assessment showed anterior and posterior intersegemental bone bridging in 77.78 % of treated levels. The X-ray fusion rate presented is comparable with those published for ALIF procedures with bone graft. Fusion rates β-TCP are similar to autologous bone. ALIF with β-TCP and additional posterior fixation is a safe and effective procedure.

  20. Magnetic hydroxyapatite bone substitutes to enhance tissue regeneration: evaluation in vitro using osteoblast-like cells and in vivo in a bone defect.

    PubMed

    Panseri, Silvia; Cunha, Carla; D'Alessandro, Teresa; Sandri, Monica; Russo, Alessandro; Giavaresi, Gianluca; Marcacci, Maurilio; Hung, Clark T; Tampieri, Anna

    2012-01-01

    In case of degenerative disease or lesion, bone tissue replacement and regeneration is an important clinical goal. In particular, nowadays, critical size defects rely on the engineering of scaffolds that are 3D structural supports, allowing cellular infiltration and subsequent integration with the native tissue. Several ceramic hydroxyapatite (HA) scaffolds with high porosity and good osteointegration have been developed in the past few decades but they have not solved completely the problems related to bone defects. In the present study we have developed a novel porous ceramic composite made of HA that incorporates magnetite at three different ratios: HA/Mgn 95/5, HA/Mgn 90/10 and HA/Mgn 50/50. The scaffolds, consolidated by sintering at high temperature in a controlled atmosphere, have been analysed in vitro using human osteoblast-like cells. Results indicate high biocompatibility, similar to a commercially available HA bone graft, with no negative effects arising from the presence of magnetite or by the use of a static magnetic field. HA/Mgn 90/10 was shown to enhance cell proliferation at the early stage. Moreover, it has been implanted in vivo in a critical size lesion of the rabbit condyle and a good level of histocompatibility was observed. Such results identify this scaffold as particularly relevant for bone tissue regeneration and open new perspectives for the application of a magnetic field in a clinical setting of bone replacement, either for magnetic scaffold fixation or magnetic drug delivery.

  1. Fabrication of Bone like Composites Material and Evaluation of its Ossiferous Ability

    NASA Astrophysics Data System (ADS)

    Hisamori, Noriyuki; Kimura, Megumi; Morisue, Hikaru; Matsumoto, Morio; Toyama, Yoshiaki

    Many kinds of materials are currently used as artificial bone substitutes. Hydroxyapatite (HA), the same as the main inorganic component of bone, is one of commonly used bio-ceramics and has excellent bioactivity and biocompatibility with hard tissues. However, it has problems as the bone filler or bone tissue-engineering scaffold due to low fracture toughness and low degradation rate. Recently, biodegradable materials for bone tissue have been developed to respond the requirement. Collagen, the same as the main organic component of bone, is biocompatible, biodegradable and promotes cell adhesion. A composites associated with HA is expected to have early osteoconduction and bone replacement ability. The present study was to fabricate bone-like composites consist of HA and collagen. Besides the ossiferous ability of the material in vivo is evaluated by using rabbits. Bone-like composites were successfully fabricated in this study, associating the collagen with HA. And the composites presented good osteoconductive and bone replacement potential.

  2. [Application of three dimensional model in evaluating the effect of artificial bone implantation of hard cleft palate on the development of maxilla].

    PubMed

    Yan, Feng-Guo; Ping, Fei-Yun; Shan, Yi-Dan; Chen, Jun; Xu, Xin; Yan, Jun-Lie

    2011-05-17

    To observe the effect of artificial bone implantation of hard cleft palate on the development of maxilla. From January 1997 to December 1999, 40 patients with hard cleft palate were randomly divided into two groups: control group and implantation group (n = 20 each). The patients in the implantation group received an implantation of compound artificial bone of HA-Bone cement. All patients had a follow-up since 16 years old. A three dimensional model was established with computed tomography and rapid prototype technique to analyze the maxilla in three dimension. At the same time, a dentognathic model was employed. There were no differences in the results between the three dimensional and dentognathic models. No difference was found in the development of maxilla in length and height between the control and implantation groups. There were marked differences in the development of maxilla in width between two groups (67.6 mm ± 4.3 mm vs 61.3 mm ± 4.1 mm, 63.5 mm ± 3.9 mm vs 57.3 mm ± 3.1 mm, 26.2 mm ± 1.8 mm vs 26.4 mm ± 1.9 mm, all P < 0.05). The width of maxilla in the implantation group was markedly wider than that in the control group. The application of three dimensional model for evaluating the development of maxilla is both straightforward and accurate. Bone implantation of hard cleft palate is an obvious boost to the development of maxilla in width. It should be included into a comprehensive orthodontic treatment for patients with hard cleft palate.

  3. Thermal evaluation by infrared measurement of implant site preparation between single and gradual drilling in artificial bone blocks of different densities.

    PubMed

    Möhlhenrich, S C; Abouridouane, M; Heussen, N; Hölzle, F; Klocke, F; Modabber, A

    2016-11-01

    The aim of this study was to investigate the influence of bone density and drilling protocol on heat generation during implant bed preparation. Ten single and 10 gradual implant sites with diameters of 2.8, 3.5, and 4.2mm were prepared in four artificial bone blocks (density types I-IV; D1-D4). Drilling was done at constant speed (1500rpm) and with external irrigation (50ml/min); vertical speed was set at 2mm/s. An infrared camera was used for temperature measurements. Significantly higher temperatures for single drilling were found between 2.8-mm drills in D1 (P=0.0014) and D4 (P<0.0001) and between 3.5-mm drills in D3 (P=0.0087) and D4 (P<0.0001), as well as between 4.2-mm drills in D1 (P<0.0001) and D4 (P=0.0014). Low bone density led to a thermal decrease after single drilling and a thermal increase after gradual drilling. Burs with a large diameter always showed a higher temperature generation. In comparisons between 2.8- and 4.2-mm diameters for both single and gradual drills, significant differences (P<0.001) were noted for bone types II, III, and IV. Single drilling could generate more heat than traditional sequential drilling, and bone density, as well as drill diameter, influenced thermal increases. Particularly in lower-density bone, conventional sequential drilling seems to raise the temperature less.

  4. Posterior Cruciate Ligament Retention or Substitution During Total Knee Arthroplasty Does Not Affect Long-Term Bone Mineral Density or Quality.

    PubMed

    Ishii, Yoshinori; Noguchi, Hideo; Sato, Junko; Todoroki, Koji; Toyabe, Shin-Ichi

    2017-04-01

    Physical activity is recognized as one of the factors that influence bone mineral density (BMD) and bone quality after total knee arthroplasty (TKA). According to biomechanical analyses after posterior cruciate ligament (PCL) retaining (PCLR) and substituting (PCLS) TKA, each implant design has different kinematics and kinetics. The purposes of this study were: (1) to perform within-patient comparisons of the midterm and long-term effects of PCL retention in mobile-bearing TKA on proximal femur and tibia BMD and calcaneus bone quality measured using ultrasound and (2) to identify correlations between them. A prospective, quasi-randomized design was used. Thirty-seven patients (74 knees) who underwent bilateral TKA (PCLR on one side and PCLS on the other) were evaluated. Mean follow-up periods were 118 months (standard deviation 40) and 117 months (standard deviation 36) in knees with PCLR and PCLS implants, respectively. The BMDs of the total hip and proximal tibia and broadband ultrasound attenuation (BUA; dB/MHz) through the calcaneus were measured. The mean BMD of PCLR and PCLS were equivalent at the proximal hip and tibia. The BUA of the calcaneus was also the same between implants. There were significant correlations between the 3 anatomic sites. When measured approximately 10 years after TKA, PCL retention had no substantial effect on the BMD of the proximal femur and tibia, or on the bone quality of the calcaneus. The measurement of noninvasive BUA may predict BMD, although further analysis is required. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Selenium-Substituted Hydroxyapatite/Biodegradable Polymer/Pamidronate Combined Scaffold for the Therapy of Bone Tumour.

    PubMed

    Oledzka, Ewa; Sobczak, Marcin; Kolmas, Joanna; Nalecz-Jawecki, Grzegorz

    2015-09-14

    The present study evaluated a new concept of combined scaffolds as a promising bone replacement material for patients with a bone tumour or bone metastasis. The scaffolds were composed of hydroxyapatite doped with selenium ions and a biodegradable polymer (linear or branched), and contained an active substance-bisphosphonate. For this purpose, a series of biodegradable polyesters were synthesized through a ring-opening polymerization of ε-caprolactone or d,l-lactide in the presence of 2-hydroxyethyl methacrylate (HEMA) or hyperbranched 2,2-bis(hydroxymethyl)propionic acid polyester-16-hydroxyl (bis-MPA) initiators, substances often used in the synthesis of medical materials. The polymers were obtained with a high yield and a number-average molecular weight up to 45,300 (g/mol). The combined scaffolds were then manufactured by a direct compression of pre-synthesized hydroxyapatite doped with selenite or selenate ions, obtained polymer and pamidronate as a model drug. It was found that the kinetic release of the drug from the scaffolds tested in vitro under physiological conditions is strongly dependent on the physicochemical properties and average molecular weight of the polymers. Furthermore, there was good correlation with the hydrolytic biodegradation results of the scaffolds fabricated without drug. The preliminary findings suggest that the fabricated combined scaffolds could be effectively used for the sustained delivery of bioactive molecules at bone defect sites.

  6. Selenium-Substituted Hydroxyapatite/Biodegradable Polymer/Pamidronate Combined Scaffold for the Therapy of Bone Tumour

    PubMed Central

    Oledzka, Ewa; Sobczak, Marcin; Kolmas, Joanna; Nalecz-Jawecki, Grzegorz

    2015-01-01

    The present study evaluated a new concept of combined scaffolds as a promising bone replacement material for patients with a bone tumour or bone metastasis. The scaffolds were composed of hydroxyapatite doped with selenium ions and a biodegradable polymer (linear or branched), and contained an active substance—bisphosphonate. For this purpose, a series of biodegradable polyesters were synthesized through a ring-opening polymerization of ε-caprolactone or d,l-lactide in the presence of 2-hydroxyethyl methacrylate (HEMA) or hyperbranched 2,2-bis(hydroxymethyl)propionic acid polyester-16-hydroxyl (bis-MPA) initiators, substances often used in the synthesis of medical materials. The polymers were obtained with a high yield and a number-average molecular weight up to 45,300 (g/mol). The combined scaffolds were then manufactured by a direct compression of pre-synthesized hydroxyapatite doped with selenite or selenate ions, obtained polymer and pamidronate as a model drug. It was found that the kinetic release of the drug from the scaffolds tested in vitro under physiological conditions is strongly dependent on the physicochemical properties and average molecular weight of the polymers. Furthermore, there was good correlation with the hydrolytic biodegradation results of the scaffolds fabricated without drug. The preliminary findings suggest that the fabricated combined scaffolds could be effectively used for the sustained delivery of bioactive molecules at bone defect sites. PMID:26389884

  7. pHEMA-nHA encapsulation and delivery of vancomycin and rhBMP-2 enhances its role as a bone graft substitute.

    PubMed

    Li, Xinning; Xu, Jianwen; Filion, Tera M; Ayers, David C; Song, Jie

    2013-08-01

    Bone grafts are widely used in orthopaedic procedures. Autografts are limited by donor site morbidity while allografts are known for considerable infection and failure rates. A synthetic composite bone graft substitute poly(2-hydroxyethyl methacrylate)-nanocrystalline hydroxyapatite (pHEMA-nHA) was previously developed to stably press-fit in and functionally repair critical-sized rat femoral segmental defects when it was preabsorbed with a single low dose of 300 ng recombinant human bone morphogenetic protein-2/7 (rhBMP-2/7). To facilitate clinical translation of pHEMA-nHA as a synthetic structural bone graft substitute, we examined its ability to encapsulate and release rhBMP-2 and the antibiotic vancomycin. We analyzed the compressive behavior and microstructure of pHEMA-nHA as a function of vancomycin incorporation doses using a dynamic mechanical analyzer and a scanning electron microscope. In vitro release of vancomycin was monitored by ultraviolet-visible spectroscopy. Release of rhBMP-2 from pHEMA-nHA-vancomycin was determined by ELISA. Bioactivity of the released vancomycin and rhBMP-2 was examined by bacterial inhibition and osteogenic transdifferentiation capabilities in cell culture, respectively. Up to 4.8 wt% of vancomycin was incorporated into pHEMA-nHA without compromising its structural integrity and compressive modulus. Encapsulated vancomycin was released in a dose-dependent and sustained manner in phosphate-buffered saline over 2 weeks, and the released vancomycin inhibited Escherichia coli culture. The pHEMA-nHA-vancomycin composite released preabsorbed rhBMP-2 in a sustained manner over 8 days and locally induced osteogenic transdifferentiation of C2C12 cells in culture. pHEMA-nHA can encapsulate and deliver vancomycin and rhBMP-2 in a sustained and localized manner with reduced loading doses. The elasticity, osteoconductivity, and rhBMP-2/vancomycin delivery characteristics of pHEMA-nHA may benefit orthopaedic reconstructions or fusions with

  8. Silicon Matrix Calcium Phosphate as a Bone Substitute: Early Clinical and Radiological Results in a Prospective Study With 12-Month Follow-up

    PubMed Central

    Pesántez, Carlos Fernando Arias; Oliveira, Leonardo

    2008-01-01

    Introduction Autograft has been the “gold standard” for orthopedic bone grafting applications, but with some clinical challenges. Here we present the rationale and clinical outcomes supporting the use of a bone substitute material that consists of a mixture of two calcium phosphates (HA and ß-TCP), which are integrated into a silicon xerogel matrix, promoting nanocrystalline apatite layers on the surface of the material following implantation into a physiological environment. Methods Twenty-four patients with a median age of 53.80 (36–81) years underwent lumbar spinal fusion for degenerative disease, selected by clinical presentation, X-rays, and MRI findings. Subjects were evaluated preoperatively and postoperatively at 1, 3, 6, and 12 months. The outcome assessment consisted of visual analog scale (VAS), Oswestry Disability Index (ODI), and radiological assessment analyzing the state of fusion on X-ray and CT evaluation by 3 independent radiologists. Results All patients completed 12-month follow-up. The mean VAS decreased from 9.3 (± 0.9) to 2.4 (± 1.6) and the mean ODI decreased from 55.0 (± 9.2) to 19.3 (± 11.4) at 12-month follow-up. Three months after surgery, 10 patients (41.67%) had solid fusion based on analysis of CT scans and dynamic radiographs. At 6 months postoperatively, the fusion rate had increased to 75% (18 patients). Twelve months after surgery, 95.83% of patients had solid fusion (23 patients). Conclusions The clinical results from this study of silicon matrix calcium phosphate are consistent with previous in vitro studies indicating that this material stimulates formation of a bioactive layer and provides an effective bone graft material for lumbar fusion applications. In comparison with previous studies involving rhBMP-2, silicon matrix calcium phosphate provided a lower fusion rate at 3- and 6-month follow-up points, but after 12 months, the fusion rate was similar, with no statistical differences and lower overall costs. No

  9. Effects of altered crystalline structure and increased initial compressive strength of calcium sulfate bone graft substitute pellets on new bone formation.

    PubMed

    Urban, Robert M; Turner, Thomas M; Hall, Deborah J; Infanger, Susan I; Cheema, Naveed; Lim, Tae-Hong; Moseley, Jon; Carroll, Michael; Roark, Michael

    2004-01-01

    A new, modified calcium sulfate has been developed with a different crystalline structure and a compressive strength similar to many calcium phosphate materials, but with a resorption profile only slightly slower than conventional surgical-grade calcium sulfate. A canine bilateral defect model was used to compare restoration of defects treated with the modified calcium sulfate compared to treatment using conventional calcium sulfate pellets after 6, 13, and 26 weeks. The modified calcium sulfate pellets were as effective as conventional calcium sulfate pellets with regard to the area fraction and compressive strength of newly formed bone in the treated bone defects. Mechanical testing demonstrated that the initial compressive strength of the modified material was increased nearly three-fold compared to that of conventional surgical-grade calcium sulfate. This increase potentially allows for its use in a broader range of clinical applications, such as vertebral and subchondral defects.

  10. Influence of substituting B2O3 for CaF2 on the bonding behaviour to bone of glass-ceramics containing apatite and wollastonite.

    PubMed

    Kitsugi, T; Yamamuro, T; Nakamura, T; Yoshii, S; Kokubo, T; Takagi, M; Shibuya, T

    1992-01-01

    Glass-ceramics containing crystalline oxy-fluoroapatite (Ca10(PO4)6(O,F2)) and wollastonite (CaSiO3) (designated AWGC) are reported to have a fairly high mechanical strength as well as the capability of forming a chemical bond with bone tissue. The chemical composition is MgO 4.6, CaO 44.9, SiO2 34.2, P2O5 16.3, and CaF2 0.5 in weight ratio. In this study the influence of substituting B2O3 for CaF2 on the bonding behaviour of glass-ceramics containing apatite and wollastonite to bone tissue was investigated. Two kinds of glass-ceramics containing apatite and wollastonite were prepared. CaF2 0.5 was replaced with B2O3 at 0.5 and 2.0 in weight ratio (designated AWGC-0.5B and AWGC-2.0B). Rectangular ceramic plates (15 x 10 x 2 mm, abraded with No. 2000 alumina powder) were implanted into a rabbit tibia. The failure load, when an implant detached from the bone, or the bone itself broke, was measured. The failure load of AWGC-0.5B was 8.00 +/- 1.82 kg at 10 weeks after implantation and 8.16 +/- 1.36 kg at 25 weeks after implantation. The failure load of AWGC-2B was 8.08 +/- 1.70 kg at 10 weeks after implantation and 9.92 +/- 2.46 kg at 25 weeks after implantation. None of the loads for the two kinds of glass-ceramics decreased as time passed. Giemsa surface staining and contact microradiography revealed direct bonding between glass-ceramics and bone. SEM-EPMA showed a calcium-phosphorus rich layer (reaction zone) at the interface of ceramics and bone tissue. The thickness of the reaction zone was 10 to -15 microns and did not increase as time passed.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Negative effect of rapidly resorbing properties of bioactive glass-ceramics as bone graft substitute in a rabbit lumbar fusion model.

    PubMed

    Lee, Jae Hyup; Ryu, Hyun-Seung; Seo, Jun-Hyuk; Lee, Do-Yoon; Chang, Bong-Soon; Lee, Choon-Ki

    2014-03-01

    Bioactive glass-ceramics have the ability to directly bind to bones and have been widely used as bone graft substitutes due to their high osteoconductivity and biocompatibility. CaO-SiO2-P2O5-B2O3 glass-ceramics are known to have good osteoconductivity and are used as bone graft extenders. This study aimed to evaluate the effects of the resorbing properties of glass-ceramics in bone fusion after producing and analyzing three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with high osteoconductivity that had enhanced resorption by having an increased B2O3 content. The three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with B2O3 contents of 8.0, 9.0, and 9.5 weight % were designated and grouped as P20B80, P10B90, and P5B95, respectively. Glass-ceramic types were tested for fusion rates and bone formation by employing the lumbar 5-6 intertransverse process fusion model in 51 New Zealand male rabbits. Bioactivity was assessed by soaking in simulated body fluid (SBF). In vitro study results showed sufficient hydroxycarbonate apatite layer formation occurred for P20B80 in1 day, for P10B90 in 3 days, and for P5B95 in 5 days after soaking in SBF. For the rabbit lumbar spine posterolateral fusion model, the autograft group recorded a 100% fusion rate with levels significantly higher than those of P20B80 (29.4%), P10B90 (0%), and P5B95 (14.3%), with high resorbing properties. Resorbing property differences among the three glass-ceramic groups were not significant. Histological results showed new bone formation confirming osteoconductivity in all three types of glass-ceramics. Radiomorphometric results also confirmed the resorbing properties of the three glass-ceramic types. The high resorbing properties and osteoconductivity of porous glass-ceramics can be advantageous as no glass-ceramics remain in the body. However, their relatively fast rate of resorption in the body negatively affects their role as an osteoconductive scaffold as glass-ceramics are resorbed before bony fusion.

  12. Negative Effect of Rapidly Resorbing Properties of Bioactive Glass-Ceramics as Bone Graft Substitute in a Rabbit Lumbar Fusion Model

    PubMed Central

    Lee, Jae Hyup; Ryu, Hyun-Seung; Seo, Jun-Hyuk; Lee, Do-Yoon; Chang, Bong-Soon

    2014-01-01

    Background Bioactive glass-ceramics have the ability to directly bind to bones and have been widely used as bone graft substitutes due to their high osteoconductivity and biocompatibility. CaO-SiO2-P2O5-B2O3 glass-ceramics are known to have good osteoconductivity and are used as bone graft extenders. Methods This study aimed to evaluate the effects of the resorbing properties of glass-ceramics in bone fusion after producing and analyzing three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with high osteoconductivity that had enhanced resorption by having an increased B2O3 content. The three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with B2O3 contents of 8.0, 9.0, and 9.5 weight % were designated and grouped as P20B80, P10B90, and P5B95, respectively. Glass-ceramic types were tested for fusion rates and bone formation by employing the lumbar 5-6 intertransverse process fusion model in 51 New Zealand male rabbits. Bioactivity was assessed by soaking in simulated body fluid (SBF). Results In vitro study results showed sufficient hydroxycarbonate apatite layer formation occurred for P20B80 in1 day, for P10B90 in 3 days, and for P5B95 in 5 days after soaking in SBF. For the rabbit lumbar spine posterolateral fusion model, the autograft group recorded a 100% fusion rate with levels significantly higher than those of P20B80 (29.4%), P10B90 (0%), and P5B95 (14.3%), with high resorbing properties. Resorbing property differences among the three glass-ceramic groups were not significant. Histological results showed new bone formation confirming osteoconductivity in all three types of glass-ceramics. Radiomorphometric results also confirmed the resorbing properties of the three glass-ceramic types. Conclusions The high resorbing properties and osteoconductivity of porous glass-ceramics can be advantageous as no glass-ceramics remain in the body. However, their relatively fast rate of resorption in the body negatively affects their role as an osteoconductive scaffold as glass

  13. Selection of animal models for pre-clinical strategies in evaluating the fracture healing, bone graft substitutes and bone tissue regeneration and engineering.

    PubMed

    Bigham-Sadegh, Amin; Oryan, Ahmad

    2015-06-01

    In vitro assays can be useful in determining biological mechanism and optimizing scaffold parameters, however translation of the in vitro results to clinics is generally hard. Animal experimentation is a better approximation than in vitro tests, and usage of animal models is often essential in extrapolating the experimental results and translating the information in a human clinical setting. In addition, usage of animal models to study fracture healing is useful to answer questions related to the most effective method to treat humans. There are several factors that should be considered when selecting an animal model. These include availability of the animal, cost, ease of handling and care, size of the animal, acceptability to society, resistance to surgery, infection and disease, biological properties analogous to humans, bone structure and composition, as well as bone modeling and remodeling characteristics. Animal experiments on bone healing have been conducted on small and large animals, including mice, rats, rabbits, dogs, pigs, goats and sheep. This review also describes the molecular events during various steps of fracture healing and explains different means of fracture healing evaluation including biomechanical, histopathological and radiological assessments.

  14. Thermal, creep-recovery and viscoelastic behavior of high density polyethylene/hydroxyapatite nano particles for bone substitutes: effects of gamma radiation.

    PubMed

    Alothman, Othman Y; Fouad, H; Al-Zahrani, S M; Eshra, Ayman; Al Rez, Mohammed Fayez; Ansari, S G

    2014-08-28

    High Density Polyethylene (HDPE) is one of the most often used polymers in biomedical applications. The limitations of HDPE are its visco-elastic behavior, low modulus and poor bioactivity. To improve HDPE properties, HA nanoparticles can be added to form polymer composite that can be used as alternatives to metals for bone substitutes and orthopaedic implant applications. In our previous work (BioMedical Engineering OnLine 2013), different ratios of HDPE/HA nanocomposites were prepared using melt blending in a co-rotating intermeshing twin screw extruder. The accelerated aging effects on the tensile properties and torsional viscoelastic behavior (storage modulus (G') and Loss modulus (G")) at 80°C of irradiated and non-irradiated HDPE/HA was investigated. Also the thermal behavior of HDPE/HA were studied. In this study, the effects of gamma irradiation on the tensile viscoelastic behavior (storage modulus (E') and Loss modulus (E")) at 25°C examined for HDPE/HA nanocomposites at different frequencies using Dynamic Mechanical Analysis (DMA). The DMA was also used to analyze creep-recovery and relaxation properties of the nanocomposites. To analyze the thermal behavior of the HDPE/HA nanocomposite, Differential Scanning Calorimetry (DSC) was used. The microscopic examination of the cryogenically fractured surface revealed a reasonable distribution of HA nanoparticles in the HDPE matrix. The DMA showed that the tensile storage and loss modulus increases with increasing the HA nanoparticles ratio and the test frequency. The creep-recovery behavior improves with increasing the HA nanoparticle content. Finally, the results indicated that the crystallinity, viscoelastic, creep recovery and relaxation behavior of HDPE nanocomposite improved due to gamma irradiation. Based on the experimental results, it is found that prepared HDPE nanocomposite properties improved due to the addition of HA nanoparticles and irradiation. So, the prepared HDPE/HA nanocomposite appears to

  15. The influence of different cellulose ethers on both the handling and mechanical properties of calcium phosphate cements for bone substitution.

    PubMed

    Liu, Weizhen; Zhang, Jingtao; Weiss, Pierre; Tancret, Franck; Bouler, Jean-Michel

    2013-03-01

    The influence of cellulose ether additives (CEAs) on the performance of final calcium phosphate cement (CPC) products is thoroughly investigated. Four CEAs were added into the liquid phase of apatitic CPCs based on the hydrolysis of α-tricalcium phosphate, to investigate the influence of both molecular weight and degree of substitution on the CPCs' properties, including handling (e.g. injectability, cohesion, washout resistance and setting time), microstructure (e.g. porosity and micromorphology) and mechanical properties (e.g. fracture toughness and compressive strength). The results showed that even a small amount of CEAs modified most of these CPCs' features, depending on the structural parameters of the CEAs. The CEAs dramatically improved the injectability, cohesion and washout resistance of the pastes, prolonged the final setting time and increased the porosity of CPCs. Moreover, the CEAs had an evident toughening effect on CPCs, and this effect become more significant with increasing molecular weight and mass fraction of CEAs, inducing a significant tolerance to damage. Overall, the molecular weight of CEAs played a major role compared to their degree of substitution in CPCs' performances.

  16. A bio-artificial poly([D,L]-lactide-co-glycolide) drug-eluting nanofibrous periosteum for segmental long bone open fractures with significant periosteal stripping injuries.

    PubMed

    Chou, Ying-Chao; Cheng, Yi-Shiun; Hsu, Yung-Heng; Yu, Yi-Hsun; Liu, Shih-Jung

    2016-01-01

    Biodegradable poly([D,L]-lactide-co-glycolide) (PLGA) nanofibrous membrane embedded with two drug-to-polymer weight ratios, namely 1:3 and 1:6, which comprised PLGA 180 mg, lidocaine 20 mg, vancomycin 20 mg, and ceftazidime 20 mg, and PLGA 360 mg, lidocaine 20 mg, vancomycin 20 mg, and ceftazidime 20 mg, respectively, was produced as an artificial periosteum in the treatment of segmental femoral fractures. The nanofibrous membrane's drug release behavior was assessed in vitro using high-performance liquid chromatography and the disk-diffusion method. A femoral segmental fracture model with intramedullary Kirschner-wire fixation was established for the in vivo rabbit activity study. Twenty-four rabbits were divided into two groups. Twelve rabbits in group A underwent femoral fracture fixation only, and 12 rabbits in group B underwent femoral fracture fixation and were administered the drug-loaded nanofibers. Radiographs obtained at 2, 6, and 12 weeks postoperatively were used to assess the bone unions. The total activity counts in animal behavior cages were also examined to evaluate the clinical performance of the rabbits. After the animals were euthanized, both femoral shafts were harvested and assessed for their torque strengths and toughness. The daily in vitro release curve for lidocaine showed that the nanofibers eluted effective levels of lidocaine for longer than 3 weeks. The bioactivity studies of vancomycin and ceftazidime showed that both antibiotics had effective and sustained bactericidal capacities for over 30 days. The findings from the in vivo animal activity study suggested that the rabbits with the artificial drug-eluting periosteum exhibited statistically increased levels of activity and better clinical performance outcomes compared with the rabbits without the artificial periosteum. In conclusion, this artificial drug-eluting periosteum may eventually be used for the treatment of open fractures.

  17. A bio-artificial poly([d,l]-lactide-co-glycolide) drug-eluting nanofibrous periosteum for segmental long bone open fractures with significant periosteal stripping injuries

    PubMed Central

    Chou, Ying-Chao; Cheng, Yi-Shiun; Hsu, Yung-Heng; Yu, Yi-Hsun; Liu, Shih-Jung

    2016-01-01

    Biodegradable poly([d,l]-lactide-co-glycolide) (PLGA) nanofibrous membrane embedded with two drug-to-polymer weight ratios, namely 1:3 and 1:6, which comprised PLGA 180 mg, lidocaine 20 mg, vancomycin 20 mg, and ceftazidime 20 mg, and PLGA 360 mg, lidocaine 20 mg, vancomycin 20 mg, and ceftazidime 20 mg, respectively, was produced as an artificial periosteum in the treatment of segmental femoral fractures. The nanofibrous membrane’s drug release behavior was assessed in vitro using high-performance liquid chromatography and the disk-diffusion method. A femoral segmental fracture model with intramedullary Kirschner-wire fixation was established for the in vivo rabbit activity study. Twenty-four rabbits were divided into two groups. Twelve rabbits in group A underwent femoral fracture fixation only, and 12 rabbits in group B underwent femoral fracture fixation and were administered the drug-loaded nanofibers. Radiographs obtained at 2, 6, and 12 weeks postoperatively were used to assess the bone unions. The total activity counts in animal behavior cages were also examined to evaluate the clinical performance of the rabbits. After the animals were euthanized, both femoral shafts were harvested and assessed for their torque strengths and toughness. The daily in vitro release curve for lidocaine showed that the nanofibers eluted effective levels of lidocaine for longer than 3 weeks. The bioactivity studies of vancomycin and ceftazidime showed that both antibiotics had effective and sustained bactericidal capacities for over 30 days. The findings from the in vivo animal activity study suggested that the rabbits with the artificial drug-eluting periosteum exhibited statistically increased levels of activity and better clinical performance outcomes compared with the rabbits without the artificial periosteum. In conclusion, this artificial drug-eluting periosteum may eventually be used for the treatment of open fractures. PMID:27022261

  18. Prediction of elasticity constants in small biomaterial samples such as bone. A comparison between classical optimization techniques and identification with artificial neural networks.

    PubMed

    Lucchinetti, E; Stüssi, E

    2004-01-01

    Measuring the elasticity constants of biological materials often sets important constraints, such as the limited size or the irregular geometry of the samples. In this paper, the identification approach as applied to the specific problem of accurately retrieving the material properties of small bone samples from a measured displacement field is discussed. The identification procedure can be formulated as an optimization problem with the goal of minimizing the difference between computed and measured displacements by searching for an appropriate set of material parameters using dedicated algorithms. Alternatively, the backcalculation of the material properties from displacement maps can be implemented using artificial neural networks. In a practical situation, however, measurement errors strongly affect the identification results, calling for robust optimization approaches in order accurately to retrieve the material properties from error-polluted sample deformation maps. Using a simple model problem, the performances of both classical and neural network driven optimization are compared. When performed before the collection of experimental data, this evaluation can be very helpful in pinpointing potential problems with the envisaged experiments such as the need for a sufficient signal-to-noise ratio, particularly important when working with small tissue samples such as specimens cut from rodent bones or single bone trabeculae.

  19. The effect of immobilization of heparin and bone morphogenic protein-2 to bovine bone substitute on osteoblast-like cell's function

    PubMed Central

    Huh, Jung-Bo; Kim, Sung-Eun; Song, Se-Kyung; Yun, Mi-Jung; Shim, Ji-Suk; Lee, Jeong-Yol

    2011-01-01

    PURPOSE This study was performed to investigate the ability of recombinant human-bone morphogenic protein-2 immobilized on a heparin-grafted bone substrate to enhance the osteoblastic functions. MATERIALS AND METHODS The Bio-Oss®, not coated with any material, was used as a control group. In rhBMP-2-Bio-Oss® group, rhBMP-2 was coated with Bio-Oss® using only deep and dry methods (50 ng/mL, 24 h). In heparinized rhBMP-2-Bio-Oss® group, dopamine was anchored to the surface of Bio-Oss®, and coated with heparin. rhBMP-2 was immobilized onto the heparinized- Bio-Oss® surface. The release kinetics of the rhBMP-2-Bio-Oss® and heparinized rhBMP-2-Bio-Oss® were analyzed using an enzyme-linked immunosorbent assay. The biological activities of the MG63 cells on the three groups were investigated via cytotoxicity assay, cell proliferation assay, alkaline phosphatase (ALP) measurement, and calcium deposition determination. Statistical comparisons were carried out by one-way ANOVA test. Differences were considered statistically significant at *P<.05 and **P<.001. RESULTS The heparinized rhBMP-2-Bio-Oss® showed more sustained release compared to the rhBMP-2-Bio-Oss® over an extended time. In the measurement of the ALP activity, the heparinized group showed a significantly higher ALP activity when compared with the non-heparinized groups (P<.05). The MG63 cells cultivated in the group with rhBMP-2 showed increased calcium deposition, and the MG63 cells from the heparinized group increased more than those that were cultivated in the non-heparinized groups. CONCLUSION Heparin increased the rhBMP-2 release amount and made sustained release possible, and heparinized Bio-Oss® with rhBMP-2 successfully improved the osteoblastic functions. PMID:22053246

  20. Bone formation in a carbonate-substituted hydroxyapatite implant is inhibited by zoledronate: the importance of bioresorption to osteoconduction.

    PubMed

    Spence, G; Phillips, S; Campion, C; Brooks, R; Rushton, N

    2008-12-01

    Carbonate-substituted hydroxyapatite (CHA) is more osteoconductive and more resorbable than hydroxyapatite (HA), but the underlying mode of its action is unclear. We hypothesised that increased resorption of the ceramic by osteoclasts might subsequently upregulate osteoblasts by a coupling mechanism, and sought to test this in a large animal model. Defects were created in both the lateral femoral condyles of 12 adult sheep. Six were implanted with CHA granules bilaterally, and six with HA. Six of the animals in each group received the bisphosphonate zoledronate (0.05 mg/kg), which inhibits the function of osteoclasts, intra-operatively. After six weeks bony ingrowth was greater in the CHA implants than in HA, but not in the animals given zoledronate. Functional osteoclasts are necessary for the enhanced osteoconduction seen in CHA compared with HA.

  1. Structural and mechanical properties of the coral and nacre and the potentiality of their use as bone substitutes

    NASA Astrophysics Data System (ADS)

    Hamza, Samir; Slimane, Noureddine; Azari, Zitouni; Pluvinage, Guy

    2013-01-01

    The main objective of this work is to develop resistant compact material samples with different porosities from coral and nacre adapted to the filling of bone cavities. The characterization of materials was conducted using scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS) and laser granulometry. The micro-hardness and the influence of porosity on the mechanical behavior of these biomaterials under compression as well as three-points bending tests were also assessed. Both materials showed similar particles size ranging from 50 to 100 μm in diameter, distributed according to the Gauss curve. The modal particle size, the median D50 and D90-D10 are the most important parameters which allow for the distinction between coral and nacre samples. The two biomaterials showed a micro hardness (138-167 HV for coral and 261-340 HV for nacre) higher than that of bovine bones (55-70 HV). The maximum compression stresses were 32.82 MPa for coral and 37.06 MPa for nacre at 50% of porosity. S-N curve with ASME format is constructed to predict the fatigue life extended from 101 to 106 cycles, which reveals an endurance limit at a compression stress ratio of about 10.

  2. A bone substitute with high affinity for vitamin D-binding protein―relationship with niche of osteoclasts

    PubMed Central

    Ikeda, Tohru; Kasai, Michiyuki; Tatsukawa, Eri; Kamitakahara, Masanobu; Shibata, Yasuaki; Yokoi, Taishi; Nemoto, Takayuki K; Ioku, Koji

    2014-01-01

    The biological activity of osteoblasts and osteoclasts is regulated not only by hormones but also by local growth factors, which are expressed in neighbouring cells or included in bone matrix. Previously, we developed hydroxyapatite (HA) composed of rod-shaped particles using applied hydrothermal methods (HHA), and it revealed mild biodegradability and potent osteoclast homing activity. Here, we compared serum proteins adsorbed to HHA with those adsorbed to conventional HA composed of globular-shaped particles (CHA). The two ceramics adsorbed serum albumin and γ-globulin to similar extents, but affinity for γ-globulin was much greater than that to serum albumin. The chemotactic activity for macrophages of serum proteins adsorbed to HHA was significantly higher than that of serum proteins adsorbed to CHA. Quantitative proteomic analysis of adsorbed serum proteins revealed preferential binding of vitamin D-binding protein (DBP) and complements C3 and C4B with HHA. When implanted with the femur of 8-week-old rats, HHA contained significantly larger amount of DBP than CHA. The biological activity of DBP was analysed and it was found that the chemotactic activity for macrophages was weak. However, DBP-macrophage activating factor, which is generated by the digestion of sugar chains of DBP, stimulated osteoclastogenesis. These results confirm that the microstructure of hydroxyapatite largely affects the affinity for serum proteins, and suggest that DBP preferentially adsorbed to HA composed of rod-shaped particles influences its potent osteoclast homing activity and local bone metabolism. PMID:24286277

  3. Porous hydroxyapatite-gelatin composites with functions of bone substitutes and drug releasing agents: A preliminary study

    NASA Astrophysics Data System (ADS)

    Sopyan, I.; Sulaiman, N. S.; Gustiono, D.; Herdianto, N.

    2006-01-01

    Biomedical composites made of porous hydroxyapatite (HA) bonded with a biodegradable polymeric matrix gelatin have been prepared. This device is expected to be useful as an excellent bone graft with bioactive hydroxyapatite which will facilitate new bone formation and at the same time it could functions as drug delivery with a controlled release rate. In this preliminary report, we wish to present preparation and physical characterization of the biomedical composite and the non-biodegradable porous hydroxyapatite composing the matrix of the composite. Porous hydroxyapatite was prepared via polymeric sponge method using hydroxyapatite nanopowders which were prepared via sol-gel procedure. Suspensions of the sol-gel derived hydroxyapatite powder was prepared with an adjusted loading of hydroxyapatite, using a dispersant. After soaking cellulosic sponges into the suspension, the sponges were dried and then subjected to heat-treatment at 600°C, followed by sintering at 1250°C for 1h. Three types of porous hydroxyapatite samples have been prepared in various composition of hydroxyapatite suspension. Porous hydroxyapatite bodies produced from slurry with less hydroxyapatite powder content and more dispersant amount yielded higher porosity and thus causing weaker compressive strength. Compressive strengths varied between 0.67 and 1.94 MPa depending on the porosity of the sample. Porosity plays important role in gelatin loading; the amount of gelatin coated on the porous hydroxyapatite bodies depend on porosity and the gelatin concentration in water solution. The higher porosity the more gelatin can be absorbed by the porous body.

  4. Research advances in artificial musk.

    PubMed

    Guo, Jing

    2014-12-01

    Based on the milestone events in the research and development of artificial musk,this artilce elucidates the applications of the musk as traditional Chinese medicine,the protection of the musk deer,the research and development principles and strategies of artificial musk. Artificial musk is a major breakthrough in research on substitutes for medicinal raw materials derived from rare animals.

  5. Large scale production of yolk-shell β-tricalcium phosphate powders, and their bioactivities as novel bone substitutes.

    PubMed

    Cho, Jung Sang; Lee, Jong-Heun; Kang, Yun Chan

    2014-08-28

    This paper proposes the production of yolk-shell structured β-tricalcium phosphate (β-TCP) powders using a spray-drying method, suitable for commercial scale production. Spray-dried precursor powders, consisting of calcium-phosphate salts and each of the various carbon source materials, are combusted in an oxygen atmosphere to obtain a yolk-shell structure. Only dextrin among the carbon source materials investigated shows promise in the production of β-TCP yolk-shell powders. By evaluating their apatite-forming capacity in simulated body fluid, the outstanding bioactivity of β-TCP yolk-shell powders is confirmed: numerous acicular and newly formed hydroxyl carbonate apatite crystals cover the entire β-TCP surface after a single day of soaking. These crystals are observed on both the outer and inner surfaces of the shells, and on the outer surface of the core, which is encouraging for its potential use as a bone grafting material.

  6. A bone substitute with high affinity for vitamin D-binding protein--relationship with niche of osteoclasts.

    PubMed

    Ikeda, Tohru; Kasai, Michiyuki; Tatsukawa, Eri; Kamitakahara, Masanobu; Shibata, Yasuaki; Yokoi, Taishi; Nemoto, Takayuki K; Ioku, Koji

    2014-01-01

    The biological activity of osteoblasts and osteoclasts is regulated not only by hormones but also by local growth factors, which are expressed in neighbouring cells or included in bone matrix. Previously, we developed hydroxyapatite (HA) composed of rod-shaped particles using applied hydrothermal methods (HHA), and it revealed mild biodegradability and potent osteoclast homing activity. Here, we compared serum proteins adsorbed to HHA with those adsorbed to conventional HA composed of globular-shaped particles (CHA). The two ceramics adsorbed serum albumin and γ-globulin to similar extents, but affinity for γ-globulin was much greater than that to serum albumin. The chemotactic activity for macrophages of serum proteins adsorbed to HHA was significantly higher than that of serum proteins adsorbed to CHA. Quantitative proteomic analysis of adsorbed serum proteins revealed preferential binding of vitamin D-binding protein (DBP) and complements C3 and C4B with HHA. When implanted with the femur of 8-week-old rats, HHA contained significantly larger amount of DBP than CHA. The biological activity of DBP was analysed and it was found that the chemotactic activity for macrophages was weak. However, DBP-macrophage activating factor, which is generated by the digestion of sugar chains of DBP, stimulated osteoclastogenesis. These results confirm that the microstructure of hydroxyapatite largely affects the affinity for serum proteins, and suggest that DBP preferentially adsorbed to HA composed of rod-shaped particles influences its potent osteoclast homing activity and local bone metabolism. © 2013 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  7. A comparative study of the use of bioactive glass S53P4 and antibiotic-loaded calcium-based bone substitutes in the treatment of chronic osteomyelitis: a retrospective comparative study.

    PubMed

    Romanò, C L; Logoluso, N; Meani, E; Romanò, D; De Vecchi, E; Vassena, C; Drago, L

    2014-06-01

    The treatment of chronic osteomyelitis often includes surgical debridement and filling the resultant void with antibiotic-loaded polymethylmethacrylate cement, bone grafts or bone substitutes. Recently, the use of bioactive glass to treat bone defects in infections has been reported in a limited series of patients. However, no direct comparison between this biomaterial and antibiotic-loaded bone substitute has been performed. In this retrospective study, we compared the safety and efficacy of surgical debridement and local application of the bioactive glass S53P4 in a series of 27 patients affected by chronic osteomyelitis of the long bones (Group A) with two other series, treated respectively with an antibiotic-loaded hydroxyapatite and calcium sulphate compound (Group B; n = 27) or a mixture of tricalcium phosphate and an antibiotic-loaded demineralised bone matrix (Group C; n = 22). Systemic antibiotics were also used in all groups. After comparable periods of follow-up, the control of infection was similar in the three groups. In particular, 25 out of 27 (92.6%) patients of Group A, 24 out of 27 (88.9%) in Group B and 19 out of 22 (86.3%) in Group C showed no infection recurrence at means of 21.8 (12 to 36), 22.1 (12 to 36) and 21.5 (12 to 36) months follow-up, respectively, while Group A showed a reduced wound complication rate. Our results show that patients treated with a bioactive glass without local antibiotics achieved similar eradication of infection and less drainage than those treated with two different antibiotic-loaded calcium-based bone substitutes.

  8. Dermal substitutes do well on dura: comparison of split skin grafting+/-artificial dermis for reconstruction of full-thickness calvarial defects.

    PubMed

    Wain, R A J; Shah, S H A; Senarath-Yapa, K; Laitung, J K G

    2010-12-01

    Large, full-thickness calvarial defects present a series of significant reconstructive challenges involving a range of techniques, including local and free flaps. Occasionally these conventional methods may not be possible due to technical, or patient, factors. Artificial dermis is already widely used in burns surgery and is increasing in oncological reconstruction. We believe that artificial dermis coupled with split-thickness skin grafting provides an excellent option for closure of these defects when other techniques are not appropriate. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Characterization of bacterial artificial chromosome transgenic mice expressing mCherry fluorescent protein substituted for the murine smooth muscle-alpha-actin gene

    USDA-ARS?s Scientific Manuscript database

    Smooth muscle a actin (SMA) is a cytoskeletal protein expressed by mesenchymal and smooth muscle cell types, including mural cells(vascular smooth muscle cells and pericytes). Using Bacterial Artificial Chromosome (BAC) recombineering technology, we generated transgenic reporter mice that express a ...

  10. Bone marrow histopathology in the diagnostic evaluation of splenic marginal-zone and splenic diffuse red pulp small B-cell lymphoma: a reliable substitute for spleen histopathology?

    PubMed

    Ponzoni, Maurilio; Kanellis, George; Pouliou, Evi; Baliakas, Panagiotis; Scarfò, Lydia; Ferreri, Andrés J M; Doglioni, Claudio; Bikos, Vasilis; Dagklis, Antonis; Anagnostopoulos, Achilles; Ghia, Paolo; Stamatopoulos, Kostas; Papadaki, Theodora

    2012-11-01

    Primary splenic small B-cell lymphomas mostly comprise the distinct entity of splenic marginal-zone lymphoma (SMZL) and the provisional category of splenic lymphoma/leukemia unclassifiable, mainly represented by the hairy cell leukemia variant and splenic diffuse red pulp small B-cell lymphoma (SDRL). Until recently, histopathologic examination of splenectomy specimens was considered mandatory for the diagnosis of SMZL. However, nowadays, mainly because of advances in chemoimmunotherapy, splenectomy is performed much less frequently. We evaluated the diagnostic efficacy of bone marrow biopsy (BMB) histopathology in the diagnostic approach toward SMZL and SDRL and tested whether it may serve as a substitute for spleen histopathology in the differential diagnosis between these 2 entities. To this end, we conducted a paired assessment of BMB and spleen diagnostic samples from 46 cases with a diagnosis of SMZL (n=32) or SDRL (n=14) based on spleen histopathology. We demonstrate that detailed immunohistopathologic BMB evaluation offers adequate evidence for the confirmation of these entities and their differential diagnosis from other small B-cell lymphoma histotypes. Notably, the immunophenotypical profile of SMZL and SDRL was identical in both BMB and spleen specimens for 21 evaluated markers. Paired assessment of BMB and spleen specimens did not identify discriminating patterns of BMB infiltration, cytology, and/or immunohistology between SMZL and SDRL. Accordingly, bone marrow histopathology contributes significantly in confirming the diagnosis of SMZL and SDRL. However, presently it is not possible to distinguish SMZL from SDRL on the basis of BMB evaluation alone; hence, histopathologic examination of the spleen remains the "gold standard" approach.

  11. In vitro evaluation of the biological compatibility and antibacterial activity of a bone substitute material consisting of silver-doped hydroxyapatite and Bio-Oss(®).

    PubMed

    Gong, Jingjue; Yang, Lei; He, Qi; Jiao, Ting

    2017-02-10

    This study evaluated biological compatibility and antibacterial activity of a bone substitute material consisting of silver-doped hydroxyapatite (AgHA) and Bio-Oss(®) with different mixture ratios in vitro and investigated its antibacterial mechanism. AgHA was synthesized by a chemical precipitation method. After characterization, AgHA was mixed with Bio-Oss(®) at three ratios: 1:1, 1:2, and 1:4 by weight. Then, Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn) were used to test the antibacterial activity of the mixture. Human periodontal ligament fibroblasts and rat bone marrow stromal cells were selected for cytocompatibility experiments. According to results, the peak value of the size of the AgHA was concentrated in the 100-200 nm range, and AgHA particles consisted of short rods. It was confirmed that the structure of AgHA was similar to that of standard hydroxyapatite. All three mixture ratios exhibited obvious antimicrobial properties, which increased with increasing AgHA. According to the effects on the expression of bacterial virulence genes, groups 1:1 and 1:2 both negatively affected Pg and Fn more significantly than group 1:4. Cytotoxicity experiments showed that 1:1 caused little cytotoxicity, while groups 1:2 and 1:4 exerted no significant cytotoxicity. Considering its biological compatibility and antibacterial activity, group 1:2 is the most recommended. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2017. © 2017 Wiley Periodicals, Inc.

  12. A comparison of Thai silk fibroin-based and chitosan-based materials on in vitro biocompatibility for bone substitutes.

    PubMed

    Vachiraroj, Nuttapon; Ratanavaraporn, Juthamas; Damrongsakkul, Siriporn; Pichyangkura, Rath; Banaprasert, Tanom; Kanokpanont, Sorada

    2009-12-01

    The novel hybrid scaffolds fabricated from silk fibroin, gelatin, low deacetylation degree chitosan and hydroxyapatite were investigated for their in vitro biocompatibility and osteoconductivity to mouse pre-osteoblast cell line (MC3T3-E1) and rat bone marrow-derived stem cells (MSC). We found that gelatin-conjugated silk fibroin films and scaffolds dominantly promoted cell adhesion and proliferation. Film and scaffold prepared from gelatin-conjugated silk fibroin with hydroxyapatite grown crystals effectively enhanced osteogenic differentiation of both cell types, as evaluated by alkaline phosphatase activity and calcium content. However the blend of hydroxyapatite/low deacetylation degree chitosan hybrid materials did not support cell growth. Furthermore, the blended hydroxyapatite in the bulk scaffold was found to be less effective for osteogenic differentiation than the scaffold with hydroxyapatite grown crystals. The comparative study between MC3T3-E1 and MSC showed that both cell types had similar trend of proliferation and osteogenic differentiation on the same material. Also, higher proliferative rate of MC3T3-E1 than MSC was observed.

  13. In vitro evaluation of alginate encapsulated adipose-tissue stromal cells for use as injectable bone graft substitute

    SciTech Connect

    Abbah, S.A.; Lu, W.W. . E-mail: wwlu@hkusua.hku.hk; Chan, D.; Cheung, K.M.C.; Liu, W.G.; Zhao, F.; Li, Z.Y.; Leong, J.C.Y.; Luk, K.D.K.

    2006-08-18

    This study aims to investigate the survival and osteogenic behavior of murine-derived adipose-tissue stromal cells (ATSCs) encapsulated in alginate microcapsules thereby instigating further studies in this cell delivery strategy for in vivo osteogenesis. Cell viability was quantified using a tetrazolium-based assay and osteogenic differentiation was evaluated by both alkaline-phosphatase (ALP) histochemistry and osteocalcin mRNA analysis. Following microencapsulation, cell numbers increased from 3.9 x 10{sup 3} on day 1 to 7.8 x 10{sup 3} on day 7 and maintained excellent viability in the course of 21-day culture. ALP was 6.9, 5.5, and 3.2 times higher than monolayer cultures on days 7, 14, and 21, respectively. In addition, osteocalcin mRNA was detectable in encapsulated cultures earlier (day 14) than monolayer cultures. We conclude that alginate microcapsules can act as three-dimensional matrix for ATSC proliferation and has potential for use as injectable, biodegradable scaffold in bone tissue engineering.

  14. The study of natural and artificial radionuclides incorporation in teeth and head bones of animals lived nearby Caetité uranium mine, Brazil.

    PubMed

    Walencik-Łata, A; Kozłowska, B; Mietelski, J W; Szufa, K; Freire, F D; Souza, S O

    2016-10-01

    This study aimed at assessing the incorporation of radionuclides in animals in the proximity of the uranium mine in Caetité, Brazil. In 2014, samples of bovine and equine teeth and skull bones were collected and their contents of natural and artificial isotopes were assessed using nuclear spectrometry techniques. Gamma ray emission from (226,228)Ra and (40)K isotopes was determined using high-purity germanium (HPGe) spectrometry, (90)Sr radioactivity was measured with liquid scintillation, and (234,238)U, (232,230,228)Th, (210)Po and (239+240)Pu radioactivity was assessed with alpha-spectrometry. Prior to the measurements, sample dissolutions and isotope separations were performed. Our results indicate a high (228)Th isotope content in the skull bones and the teeth of animals, up to 179 Bq per kg of ash. The (226)Ra and (228)Ra concentrations were slightly lower. Activity concentrations of other isotopes were significantly lower or below the detection limit. We could not identify sources of technologically enhanced levels of (228)Ra in the area we investigated; therefore we suggest that their origin is natural. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Different ratios of bone marrow mesenchymal stem cells and chondrocytes used in tissue-engineered cartilage and its application for human ear-shaped substitutes in vitro.

    PubMed

    Kang, Ning; Liu, Xia; Yan, Li; Wang, Qian; Cao, Yilin; Xiao, Ran

    2013-01-01

    The application of chondrocyte-based cartilage tissue engineering is limited because of the lack of autologous cartilage sources and chondrocyte dedifferentiation after in vitro expansion. Coculture of bone marrow mesenchymal stem cells (BMSCs) and chondrocytes has been a promising strategy for cartilage engineering as chondrocytes can provide a chondrogenic environment for BMSCs. However, there are no systematic comparison studies for engineered cartilage constructed using different mixing ratios of BMSCs and chondrocytes, and the most effective mixing ratio with the lowest number of chondrocytes is unknown. Here, we set a gradient of mixing ratios of BMSCs to chondrocytes for an in vitro coculture system and compared the shape retention and quality of the engineered cartilage using macroscopic and histological assays, glycosaminoglycan content assessment and immunohistochemical staining of type II collagen, biomechanical evaluation and hypertrophy-related gene expression analysis. The results showed that at least 30% chondrocytes were required to generate cartilage tissue with satisfactory shape and quality. Therefore, we preliminarily assessed the feasibility of engineering a human ear-shaped substitute using a coculture system with a 7:3 ratio of BMSCs to chondrocytes. After 8 weeks of in vitro culture, the precise architecture of the human ear-shaped construct was well maintained with the typical cartilaginous composition confirmed by histological assays.

  16. Accuracy of Cone Beam Computed Tomography, Photostimulable Phosphor Plate Digital Radiography and Conventional Radiography for Detection of Artificial Cancellous Bone Defects.

    PubMed

    Bardal, Roghieh; Jahanihashemi, Hassan; Mostafavi, Maryam; Kalhor, Esmaeil; Tofangchiha, Maryam; Dehghani, Mahdieh

    2015-11-01

    The optimal goal of radiography is to provide high-quality diagnostic images with the least patient radiation dose. The aim of this study was to evaluate the accuracy of cone-beam computed tomography (CBCT) and intraoral photostimulable phosphor plate (PSP) digital and film-based conventional radiography for detection of artificial cancellous bone defects. Five dry human mandibles were used in this study. The mandibles were placed inside a water bath made of plexiglass plates; then PSP and CBCT scans were obtained. The mandibles were cut by a coping saw in buccolingual dimension and oval defects measuring 6.1×6.1 mm, 3×6.1 mm and 4×4 mm were created by a milling machine in the spongy bone. After fixing the two parts together (buccal and lingual), radiographs were repeated. Presence or absence of defects on images was evaluated and recorded by the two observers. Using SPSS 16, compatibility level, sensitivity, specificity and receiver operating curve (ROC) analysis were determined for each observer. The intraobserver agreement in all three imaging modalities was low to moderate (kappa≤0.613). The inter-observer agreement in all the three imaging modalities was moderate (kappa=0.406). The area under the curve (AUC) of the imaging modalities in each observation was not significantly different. The area under the curve based on defect size for the two observers was not significantly different either. Defects confined to spongy bone can be identified on film and PSP radiographs and CBCT scans. However, interpretation of PSP images and CBCT scans needs greater expertise and skills.

  17. Structural Characterization of the Complex between Hen Egg-White Lysozyme and Zr(IV) -Substituted Keggin Polyoxometalate as Artificial Protease.

    PubMed

    Sap, Annelies; De Zitter, Elke; Van Meervelt, Luc; Parac-Vogt, Tatjana N

    2015-08-10

    Successful co-crystallization of a noncovalent complex between hen egg-white lysozyme (HEWL) and the monomeric Zr(IV) -substituted Keggin polyoxometalate (POM) (Zr1 K1), (Et2 NH2)3 [Zr(PW11 O39)] (1), has been achieved, and its single-crystal X-ray structure has been determined. The dimeric Zr(IV) -substituted Keggin-type polyoxometalate (Zr1 K2), (Et2 NH2)10 [Zr(PW11 O39 )2] (2), has been previously shown to exhibit remarkable selectivity towards HEWL hydrolysis. The reported X-ray structure shows that the hydrolytically active Zr(IV) -substituted Keggin POM exists as a monomeric species. Prior to hydrolysis, this monomer interacts with HEWL in the vicinity of the previously identified cleavage sites found at Trp28-Val29 and Asn44-Arg45, through water-mediated H-bonding and electrostatic interactions. Three binding sites are observed at the interface of the negatively charged Keggin POM and the positively charged regions of HEWL at: 1) Gly16, Tyr20, and Arg21; 2) Asn44, Arg45, and Asn46; and 3) Arg128. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  18. Assessment of stiffness and strength of 4 different implants available for equine fracture treatment: a study on a 20 degrees oblique long-bone fracture model using a bone substitute.

    PubMed

    Florin, Marion; Arzdorf, Michael; Linke, Berend; Auer, Joerg A

    2005-01-01

    To compare the mechanical properties of 4 stabilization methods for equine long-bone fractures: dynamic compression plate (DCP), limited contact-DCPlate (LC-DCP), locking compression plate (LCP), and the clamp-rod internal fixator (CRIF--formerly VetFix). In vitro mechanical study. Bone substitute material (24 tubes) was cut at 20 degrees to the long axis of the tube to simulate an oblique mid-shaft fracture. Tubes were divided into 4 groups (n=6) and double plated in an orthogonal configuration, with 1 screw of 1 implant being inserted in lag fashion through the "fracture". Thus, the groups were: (1) 2 DCP implants (4.5, broad, 10 holes); (2) 2 LC-DCP implants (5.5, broad, 10 holes); (3) 2 LCP implants (4.5/5.0, broad, 10 holes) and 4 head locking screws/plate; and (4) 2 CRIF (4.5/5.0) and 10 clamps in alternating position left and right of the rod. All constructs were tested in 4-point bending with a quasi-static load until failure. The implant with the interfragmentary screw was always positioned on the tension side of the construct. Force, displacement, and angular displacement at the "fracture" line were determined. Construct stiffness under low and high loads, yield strength, ultimate strength, and maximum angular displacement were determined. None of the implants failed; the strength of the bone substitute was the limiting factor. At low loads, no differences in stiffness were found among groups, but LCP constructs were stiffer than other constructs under high loads (P=.004). Ultimate strength was lowest in the LCP group (P=.01), whereas yield strength was highest for LCP constructs (409 N m, P=.004). CRIF had the lowest yield strength (117 N m, P=.004); no differences in yield strength (250 N m) were found between DCP and LC-DCP constructs. Differences were found for maximum angular displacement at the "fracture" line, between groups: LPC

  19. Bone grafts.

    PubMed

    Hubble, Matthew J W

    2002-09-01

    Bone grafts are used in musculoskeletal surgery to restore structural integrity and enhance osteogenic potential. The demand for bone graft for skeletal reconstruction in bone tumor, revision arthroplasty, and trauma surgery, couple with recent advances in understanding and application of the biology of bone transplantation, has resulted in an exponential increase in the number of bone-grafting procedures performed over the last decade. It is estimated that 1.5 million bone-grafting procedures are currently performed worldwide each year, compared to a fraction of that number 20 years ago. Major developments also have resulted in the harvesting, storage, and use of bone grafts and production of graft derivatives, substitutes, and bone-inducing agents.

  20. Role of clinician's experience and implant design on implant stability. An ex vivo study in artificial soft bones.

    PubMed

    Romanos, Georgios E; Basha-Hijazi, Abdulaziz; Gupta, Bhumija; Ren, Yan-Fang; Malmstrom, Hans

    2014-04-01

    Clinical experience in implant placement is important in order to prevent implant failures. However, the implant design affects the primary implant stability (PS) especially in poor quality bones. Therefore, the aim of this study was to compare the effect of clinician surgical experience on PS, when placing different type of implant designs. A total of 180 implants (90 parallel walled-P and 90 tapered-T) were placed in freshly slaughtered cow ribs. Bone quality was evaluated by two examiners during surgery and considered as 'type IV' bone. Implants (ø 5 mm, length: 15 mm, Osseotite, BIOMET 3i, Palm Beach Gardens, FL, USA) were placed by three different clinicians (master/I, good/II, non-experienced/III, under direct supervision of a manufacturer representative; 30 implants/group). An independent observer assessed the accuracy of placement by resonance frequency analysis (RFA) with implant stability quotient (ISQ) values. Two-way analysis of variance (ANOVA) and Tukey's post hoc test were used to detect the surgical experience of the clinicians and their interaction and effects of implant design on the PS. All implants were mechanically stable. The mean ISQ values were: 49.57(± 18.49) for the P-implants and 67.07(± 8.79) for the T-implants. The two-way ANOVA showed significant effects of implant design (p < .0001), clinician (p < .0001), and their interaction (p < .0001). The Tukey's multiple comparison test showed significant differences in RFA for the clinician group I/II (p = .015) and highly significant (p < .0001) between I/III and II/III. The P-implants presented (for I, II, and III) mean ISQ values 31.25/49.18/68.17 and the T-implants showed higher ISQ values, 70.15/62.08/68.98, respectively. Clinicians I and II did not show extreme differences for T-implants (p = .016). In contrast, clinician III achieved high ISQ values using P- and T-implants following the exact surgical protocol based on the manufacturer guidelines. T

  1. Finite element analysis of Stryker Xia pedicle screw in artificial bone samples with and without supplemental cement augmentation.

    PubMed

    Pfeiffer, Ferris M; Choma, Theodore J; Kueny, Rebecca

    2015-01-01

    A validated, using in vitro biomechanical testing, finite element model was used to evaluate the affects of (1) cement augmentation and (2) an intact posterior cortex in osteoporotic bone. The presence of augmentation and/or a posterior cortical cortex increased the stabilization of the pedicle screw 2-5 fold. Placement of cement influenced failure load and toggle; with distal placement having the largest increase in failure load and decrease in cephalad-caudad toggle. The presence of posterior cortex caused a decrease in the amount of toggle, a proximal shift of the center of rotation and an increase in the maximum failure force.

  2. Is dibotermin alfa a cost-effective substitute for autologous iliac crest bone graft in single level lumbar interbody spine fusion?

    PubMed

    Svedbom, Axel; Paech, Daniel; Leonard, Catherine; Donnell, David; Song, Fujian; Boszcyk, Bronek; Rothenfluh, Dominique A; Lloyd, Andrew; Borgman, Benny

    2015-11-01

    To evaluate the cost-effectiveness of dibotermin alfa compared with autologous iliac crest bone graft (ICBG) for patients undergoing single level lumbar interbody spinal fusion in a UK hospital setting. An individual patient data (IPD) meta-analysis of six randomized controlled clinical trials and two single arm trials compared dibotermin alfa on an absorbable collagen implantation matrix (ACIM) (n = 456) and ICBG (n = 244) on resource use, re-operation rates, and SF-6D (Short form 6-dimension) health utility (total N = 700). Failure-related second surgery, operating time, post-operative hospital stay, and quality-adjusted life years (QALYs) derived from the IPD meta-analysis were included as inputs in an economic evaluation undertaken to assess the cost-effectiveness of dibotermin alfa/ACIM versus ICBG for patients undergoing single level lumbar interbody spinal fusion. A four year time horizon and the United Kingdom (UK) National Health Service (NHS) and Personal Social Services (PSS) perspective was adopted in the base case, with sensitivity analyses performed to gauge parameter uncertainty. In the base case analysis, patients treated using dibotermin alfa/ACIM (12 mg pack) accrued 0.055 incremental QALYs at an incremental cost of £ 737, compared with patients treated with ICBG. This resulted in an incremental cost-effectiveness ratio (ICER) of £ 13,523, indicating that at a willingness-to-pay threshold of £ 20,000, dibotermin alfa/ACIM is a cost-effective intervention relative to ICBG from the NHS and PSS perspective. In a UK hospital setting, dibotermin alfa/ACIM is a cost-effective substitute for ICBG for patients who require lumbar interbody arthrodesis.

  3. Effects of carboxymethyl cellulose-based saliva substitutes with varying degrees of saturation with respect to calcium phosphates on artificial enamel lesions.

    PubMed

    Meyer-Lueckel, H; Cölfen, H; Verch, A; Tschoppe, P

    2010-01-01

    The aim of the present study was to evaluate the effects of experimental saliva substitutes based on carboxymethyl cellulose (CMC) differing in degrees of saturation with respect to calcium phosphates on the mineral loss of enamel in vitro. Demineralized bovine specimens (subsurface lesions) were exposed to one of six experimental CMC-based solutions with theoretical degrees of saturation with respect to octacalcium phosphate (S(OCP)) of S0, S0.5, S1, S2, S4, and S8 for 10 weeks. A previously studied saliva substitute (Glandosane) and two aqueous solutions (C0 and C1) served as controls. Mineral losses and lesion depths before and after storage were evaluated from microradiographs. Free and bound calcium as well as phosphate and fluoride concentrations were determined. According to these measurements, S(OCP) of S2, S4, and S8 was 0.3, 1.1, and 3.4, respectively. Storage in Glandosane and both negative controls resulted in significant demineralization (p < 0.05). Only S2 significantly remineralized the specimens (p < 0.05). All other solutions showed neutral effects. No significant differences in mineralization between S0 and C0 as well as between S1 and C1 could be observed (p > 0.05). It can be concluded that a CMC-based solution actually unsaturated with respect to octacalcium phosphate (S2) shows most pronounced remineralization capability under the conditions chosen. This might be explained by a more favorable balance between calcium bound to CMC in an adsorbed layer at the enamel-liquid interface and heterogeneous nucleation of calcium phosphates within a solution compared to solutions either supersaturated or having lower levels of saturation. (c) 2010 S. Karger AG, Basel.

  4. SAR of carbon-linked, 2-substituted purines: synthesis and characterization of AP23451 as a novel bone-targeted inhibitor of Src tyrosine kinase with in vivo anti-resorptive activity.

    PubMed

    Shakespeare, William C; Wang, Yihan; Bohacek, Regine; Keenan, Terry; Sundaramoorthi, Raji; Metcalf, Chet; Dilauro, Anne; Roeloffzen, Sonya; Liu, Shuangying; Saltmarsh, Jennifer; Paramanathan, Guru; Dalgarno, David; Narula, Surinder; Pradeepan, Selvi; van Schravendijk, Marie Rose; Keats, Jeff; Ram, Mary; Liou, Shuenn; Adams, Susan; Wardwell, Scott; Bogus, Julie; Iuliucci, John; Weigele, Manfred; Xing, Lianping; Boyce, Brendan; Sawyer, Tomi K

    2008-02-01

    Targeted disruption of the pp60(src) (Src) gene has implicated this tyrosine kinase in osteoclast-mediated bone resorption and as a therapeutic target for the treatment of osteoporosis and other bone-related diseases. Here, we describe structure activity relationships of a novel series of carbon-linked, 2-substituted purines that led to the identification of AP23451 as a potent inhibitor of Src tyrosine kinase with antiresorptive activity in vivo. AP23451 features the use of an arylphosphinylmethylphosphinic acid moiety which confers bone-targeting properties to the molecule, thereby increasing local concentrations of the inhibitor to actively resorbing osteoclasts at the bone interface. AP23451 exhibited an IC50 = 68 nm against Src kinase; an X-ray crystal structure of the molecule complexed with Src detailed the molecular interactions responsible for its Src inhibition. In vivo, AP23451 demonstrated a dose-dependent decrease in PTH-induced hypercalcemia. Moreover, AP23517, a structurally and biochemically similar molecule with comparable activity (IC50 = 73 nm) except devoid of the bone-targeting element, demonstrated significantly reduced in vivo efficacy, suggesting that Src activity was necessary but not sufficient for in vivo activity in this series of compounds.

  5. Enamel matrix protein derivative and/or synthetic bone substitute for the treatment of mandibular class II buccal furcation defects. A 12-month randomized clinical trial.

    PubMed

    Queiroz, Lucas Araujo; Santamaria, Mauro Pedrine; Casati, Marcio Z; Ruiz, Karina Silverio; Nociti, Francisco; Sallum, Antonio Wilson; Sallum, Enilson A

    2016-09-01

    This study aims to clinically evaluate the treatment of mandibular class II furcation defects with enamel matrix derivative (EMD) and/or a bone substitute graft made of β-tricalcium phosphate/hydroxyapatite (βTCP/HA). Forty-one patients, presenting a mandibular class II buccal furcation defect, probing pocket depth (PPD) ≥4 mm and bleeding on probing, were included. They were randomly assigned to the groups: 1-EMD (n = 13); 2-βTCP/HA (n = 14); 3-EMD + βTCP/HA (n = 14). Plaque index (PI), gingival index (GI), relative gingival margin position (RGMP), relative vertical and horizontal attachment level (RVCAL and RHCAL), and PPD were evaluated at baseline and 6 and 12 months. The mean horizontal clinical attachment level gain was considered the primary outcome variable. No significant intragroup differences were observed for RGMP, but significant changes were observed for RVCAL, RHCAL, and PPD for all groups (p < 0.05). After 12 months, the mean horizontal clinical attachment level gain was 2.77 ± 0.93 mm for EMD, 2.64 ± 0.93 mm for βTCP/HA, and 2.93 ± 0.83 mm for EMD + βTCP/HA, with no significant differences among the groups. At the end of the study, 85.3 % of the sites were partially closed; however, no complete closure was observed. EMD + βTCP/HA does not provide a significant advantage when compared to the isolated approaches. All three tested treatments promote significant improvements and partial closure of class II buccal furcation defects. Based on its potential to induce periodontal regeneration, EMD may be considered an attractive option for this type of defect, but complete closure remains an unrealistic goal. The partial closure of buccal furcation defects can be achieved after the three tested approaches. However, the combined treatment does not provide a significant benefit when compared to the isolated approaches.

  6. Divergent rules for pollen and nectar foraging bumblebees--a laboratory study with artificial flowers offering diluted nectar substitute and pollen surrogate.

    PubMed

    Konzmann, Sabine; Lunau, Klaus

    2014-01-01

    Almost all bees collect nectar and pollen from flowers. Female bees collect pollen to provision their nest cells, whereas they use nectar for individual energy supply and nest cell provisioning. Bees fine-tune nectar foraging to the amount and to the concentration of nectar, but the individual bees' response to variability of amount and concentration of pollen reward has not yet been studied thoroughly in laboratory settings. We developed an experimental set-up in which bumblebees simultaneously collected sugar solution and pollen from artificial flowers; natural pollen was mixed with cellulose powder or glass powder as a pollen surrogate. Here we show that bumblebee (Bombus terrestris) workers do not specialise in nectar or pollen collection, but regularly collect both rewards on the same day. When offered a fixed pollen reward and varied amounts and concentrations of sugar solution, the bumblebees fine-tuned sugar solution foraging dependent on both the volume and concentration, with strong preferences for the highest concentration and the greatest volume. In the reciprocal tests, when offered a fixed sugar reward and varied amounts and concentrations of pollen mixed with a nutrient-free pollen surrogate, the bumblebees follow more an all-or-none rule for pollen, accepting all amounts and concentrations except pure surrogate. It is discussed how the bumblebees' ability to sense sugar, and their apparent inability to sense the pollen protein content, shaped their foraging behaviour. It is argued that the rarity of nectar mimicry and the frequency of pollen mimicry in natural flowers might be interpreted in the context of divergent abilities of nectar and pollen recognition in bees.

  7. Divergent Rules for Pollen and Nectar Foraging Bumblebees – A Laboratory Study with Artificial Flowers Offering Diluted Nectar Substitute and Pollen Surrogate

    PubMed Central

    Konzmann, Sabine; Lunau, Klaus

    2014-01-01

    Almost all bees collect nectar and pollen from flowers. Female bees collect pollen to provision their nest cells, whereas they use nectar for individual energy supply and nest cell provisioning. Bees fine-tune nectar foraging to the amount and to the concentration of nectar, but the individual bees' response to variability of amount and concentration of pollen reward has not yet been studied thoroughly in laboratory settings. We developed an experimental set-up in which bumblebees simultaneously collected sugar solution and pollen from artificial flowers; natural pollen was mixed with cellulose powder or glass powder as a pollen surrogate. Here we show that bumblebee (Bombus terrestris) workers do not specialise in nectar or pollen collection, but regularly collect both rewards on the same day. When offered a fixed pollen reward and varied amounts and concentrations of sugar solution, the bumblebees fine-tuned sugar solution foraging dependent on both the volume and concentration, with strong preferences for the highest concentration and the greatest volume. In the reciprocal tests, when offered a fixed sugar reward and varied amounts and concentrations of pollen mixed with a nutrient-free pollen surrogate, the bumblebees follow more an all-or-none rule for pollen, accepting all amounts and concentrations except pure surrogate. It is discussed how the bumblebees' ability to sense sugar, and their apparent inability to sense the pollen protein content, shaped their foraging behaviour. It is argued that the rarity of nectar mimicry and the frequency of pollen mimicry in natural flowers might be interpreted in the context of divergent abilities of nectar and pollen recognition in bees. PMID:24637406

  8. Bilayer oxidized regenerated cellulose/poly ε-caprolactone knitted fabric-reinforced composite for use as an artificial dural substitute.

    PubMed

    Suwanprateeb, Jintamai; Luangwattanawilai, Ticomporn; Theeranattapong, Thunyanun; Suvannapruk, Waraporn; Chumnanvej, Sorayouth; Hemstapat, Warinkarn

    2016-07-01

    A novel bilayer knitted fabric-reinforced composite for potentially being used as a dural substitute was developed by solution infiltration of oxidized regenerated cellulose knitted fabric (ORC) with poly ε-caprolactone (PCL) solution at various concentrations ranging 10-40 g/100 mL. It was found that the density of all formulations did not differ significantly and was lower than that of the human dura. Microstructure of the samples typically comprised a bilayer structure having a nonporous PCL layer on one side and the ORC/PCL composite layer on another side. Tensile modulus and strength of the samples initially decreased with increasing PCL solution concentration for up to 20 g/100 mL and re-increased again with further increasing PCL solution concentration. Strain at break of all formulations were not significantly different. Watertight test revealed that all composites could prevent leakage at the pressure within the normal range of intracranial pressure. In vitro degradation study revealed that the weight loss percentage and change in tensile properties of all samples displayed biphasic profile comprising an initially rapid decrease and followed by a gradual decrease with incubation times afterward. Micro and macro porous channels were observed to be in situ generated in the composite layer by ORC dissolution and PCL resorption during degradation while nonporous layer remained relatively unchanged. The degradation rate was found to decrease with increasing PCL solution concentration. In vitro biocompatibility using alamar blue assay on selected samples showed that fibroblasts could attach and proliferate well at all incubation periods.

  9. Artificial gravity.

    PubMed

    Scott, William B

    2005-04-25

    NASA's Artificial Gravity program consists of a team of researchers from Wyle Laboratories, NASA Johnson Space Center, and the University of Texas Medical Branch (UTMB). The short-radius centrifuge (SRC), built by Wyle Laboratories, will be integrated with UTMB's conducted bedrest studies, which mimic the detrimental effects of weightlessness (or microgravity). Bedrest subjects will be spun on the SRC at various accelerations and for various time periods, while being monitored medically. Parameters such as bone loss, muscle atrophy, balance control, and oxygen consumption will then be compared in order to research ways of mitigating the impact on astronauts' physiology. Other potential benefits from these studies extend to population groups on Earth, such as bedridden patients.

  10. The 1999 clinical research award. Cultured skin substitutes combined with Integra Artificial Skin to replace native skin autograft and allograft for the closure of excised full-thickness burns.

    PubMed

    Boyce, S T; Kagan, R J; Meyer, N A; Yakuboff, K P; Warden, G D

    1999-01-01

    Prompt and permanent closure of excised full-thickness burns remains a critical factor in a patient's recovery from massive burn injuries. Hypothetically, Integra Artificial Skin (Integra) may replace the need for allografts for immediate wound coverage, and cultured skin substitutes (CSS) that contain stratified epithelium may replace the need for autografts for definitive wound closure. To test this hypothesis, 3 patients with full-thickness burns of greater than 60% of their total body surface areas had their eschar excised within 14 days of admission. Integra was applied, and a skin biopsy was collected from each patient for the preparation of CSS. At 3 weeks or more after the application of the Integra and the collection of skin biopsies, the outer silastic cover of the Integra was removed and CSS were grafted. The CSS were irrigated with nutrients and antimicrobials for 6 days and then dressed with antimicrobial ointment and cotton gauze. Treated wounds were traced on days 14 and 28 after the grafting of CSS for determination of engraftment and wound closure, respectively. Cost analysis was not performed. Engraftment on postoperative day (POD) 14 was 98%+/-1% (mean +/- standard error of the mean), the ratio of closed:donor areas on POD 28 was 52.3+/-5.2, and no treated sites required regrafting. The histology of the closed wounds showed stable epithelium that covered a layer of newly formed fibrovascular tissue above the reticulated structure of the degrading Integra. The clinical outcomes of the closed wounds after POD 28 demonstrated smooth, pliable, and hypopigmented skin. Two patients who had received CSS grafts over Integra on their backs were positioned supine on air beds from POD 8 or POD 9 with minimal graft loss because of mechanical loading. One patient with a full-thickness burn of 88% of the total body surface area was covered definitively at 55 days postburn. These results demonstrate that the combination of CSS and Integra can accomplish

  11. Polymeric scaffolds as stem cell carriers in bone repair.

    PubMed

    Rossi, Filippo; Santoro, Marco; Perale, Giuseppe

    2015-10-01

    Although bone has a high potential to regenerate itself after damage and injury, the efficacious repair of large bone defects resulting from resection, trauma or non-union fractures still requires the implantation of bone grafts. Materials science, in conjunction with biotechnology, can satisfy these needs by developing artificial bones, synthetic substitutes and organ implants. In particular, recent advances in polymer science have provided several innovations, underlying the increasing importance of macromolecules in this field. To address the increasing need for improved bone substitutes, tissue engineering seeks to create synthetic, three-dimensional scaffolds made from polymeric materials, incorporating stem cells and growth factors, to induce new bone tissue formation. Polymeric materials have shown a great affinity for cell transplantation and differentiation and, moreover, their structure can be tuned in order to maintain an adequate mechanical resistance and contemporarily be fully bioresorbable. This review emphasizes recent progress in polymer science that allows relaible polymeric scaffolds to be synthesized for stem cell growth in bone regeneration.

  12. Artificial limb connection

    NASA Technical Reports Server (NTRS)

    Owens, L. J.

    1974-01-01

    Connection simplifies and eases donning and removing artificial limb; eliminates harnesses and clamps; and reduces skin pressures by allowing bone to carry all tensile and part of compressive loads between prosthesis and stump. Because connection is modular, it is easily modified to suit individual needs.

  13. Mesenchymal stem cells and platelet gel improve bone deposition within CAD-CAM custom-made ceramic HA scaffolds for condyle substitution.

    PubMed

    Ciocca, L; Donati, D; Ragazzini, S; Dozza, B; Rossi, F; Fantini, M; Spadari, A; Romagnoli, N; Landi, E; Tampieri, A; Piattelli, A; Iezzi, G; Scotti, R

    2013-01-01

    This study evaluated the efficacy of a regenerative approach using mesenchymal stem cells (MSCs) and CAD-CAM customized pure and porous hydroxyapatite (HA) scaffolds to replace the temporomandibular joint (TMJ) condyle. Pure HA scaffolds with a 70% total porosity volume were prototyped using CAD-CAM technology to replace the two temporomandibular condyles (left and right) of the same animal. MSCs were derived from the aspirated iliac crest bone marrow, and platelets were obtained from the venous blood of the sheep. Custom-made surgical guides were created by direct metal laser sintering and were used to export the virtual planning of the bone cut lines into the surgical environment. Sheep were sacrificed 4 months postoperatively. The HA scaffolds were explanted, histological specimens were prepared, and histomorphometric analysis was performed. Analysis of the porosity reduction for apposition of newly formed bone showed a statistically significant difference in bone formation between condyles loaded with MSC and condyles without (P < 0.05). The bone ingrowth (BI) relative values of split-mouth comparison (right versus left side) showed a significant difference between condyles with and without MSCs (P < 0.05). Analysis of the test and control sides in the same animal using a split-mouth study design was performed; the condyle with MSCs showed greater bone formation. The split-mouth design confirmed an increment of bone regeneration into the HA scaffold of up to 797% upon application of MSCs.

  14. Mesenchymal Stem Cells and Platelet Gel Improve Bone Deposition within CAD-CAM Custom-Made Ceramic HA Scaffolds for Condyle Substitution

    PubMed Central

    Ciocca, L.; Donati, D.; Ragazzini, S.; Dozza, B.; Rossi, F.; Fantini, M.; Spadari, A.; Romagnoli, N.; Landi, E.; Tampieri, A.; Piattelli, A.; Iezzi, G.; Scotti, R.

    2013-01-01

    Purpose. This study evaluated the efficacy of a regenerative approach using mesenchymal stem cells (MSCs) and CAD-CAM customized pure and porous hydroxyapatite (HA) scaffolds to replace the temporomandibular joint (TMJ) condyle. Methods. Pure HA scaffolds with a 70% total porosity volume were prototyped using CAD-CAM technology to replace the two temporomandibular condyles (left and right) of the same animal. MSCs were derived from the aspirated iliac crest bone marrow, and platelets were obtained from the venous blood of the sheep. Custom-made surgical guides were created by direct metal laser sintering and were used to export the virtual planning of the bone cut lines into the surgical environment. Sheep were sacrificed 4 months postoperatively. The HA scaffolds were explanted, histological specimens were prepared, and histomorphometric analysis was performed. Results. Analysis of the porosity reduction for apposition of newly formed bone showed a statistically significant difference in bone formation between condyles loaded with MSC and condyles without (P < 0.05). The bone ingrowth (BI) relative values of split-mouth comparison (right versus left side) showed a significant difference between condyles with and without MSCs (P < 0.05). Analysis of the test and control sides in the same animal using a split-mouth study design was performed; the condyle with MSCs showed greater bone formation. Conclusion. The split-mouth design confirmed an increment of bone regeneration into the HA scaffold of up to 797% upon application of MSCs. PMID:24073409

  15. A comparative study of the effects of different bioactive fillers in PLGA matrix composites and their suitability as bone substitute materials: A thermo-mechanical and in vitro investigation.

    PubMed

    Simpson, R L; Nazhat, S N; Blaker, J J; Bismarck, A; Hill, R; Boccaccini, A R; Hansen, U N; Amis, A A

    2015-10-01

    Bone substitute composite materials with poly(L-lactide-co-glycolide) (PLGA) matrices and four different bioactive fillers: CaCO3, hydroxyapatite (HA), 45S5 Bioglass(®) (45S5 BG), and ICIE4 bioactive glass (a lower sodium glass than 45S5 BG) were produced via melt blending, extrusion and moulding. The viscoelastic, mechanical and thermal properties, and the molecular weight of the matrix were measured. Thermogravimetric analysis evaluated the effect of filler composition on the thermal degradation of the matrix. Bioactive glasses caused premature degradation of the matrix during processing, whereas CaCO3 or HA did not. All composites, except those with 45S5 BG, had similar mechanical strength and were stiffer than PLGA alone in compression, whilst all had a lower tensile strength. Dynamic mechanical analysis demonstrated an increased storage modulus (E') in the composites (other than the 45S5 BG filled PLGA). The effect of water uptake and early degradation was investigated by short-term in vitro aging in simulated body fluid, which indicated enhanced water uptake over the neat polymer; bioactive glass had the greatest water uptake, causing matrix plasticization. These results enable a direct comparison between bioactive filler type in poly(α-hydroxyester) composites, and have implications when selecting a composite material for eventual application in bone substitution.

  16. Orthopaedic tissue engineering and bone regeneration.

    PubMed

    Dickson, Glenn; Buchanan, Fraser; Marsh, David; Harkin-Jones, Eileen; Little, Uel; McCaigue, Mervyn

    2007-01-01

    Orthopaedic tissue engineering combines the application of scaffold materials, cells and the release of growth factors. It has been described as the science of persuading the body to reconstitute or repair tissues that have failed to regenerate or heal spontaneously. In the case of bone regeneration 3-D scaffolds are used as a framework to guide tissue regeneration. Mesenchymal cells obtained from the patient via biopsy are grown on biomaterials in vitro and then implanted at a desired site in the patient's body. Medical implants that encourage natural tissue regeneration are generally considered more desirable than metallic implants that may need to be removed by subsequent intervention. Numerous polymeric materials, from natural and artificial sources, are under investigation as substitutes for skeletal elements such as cartilage and bone. For bone regeneration, cells (obtained mainly from bone marrow aspirate or as primary cell outgrowths from bone biopsies) can be combined with biodegradable polymeric materials and/or ceramics and absorbed growth factors so that osteoinduction is facilitated together with osteoconduction; through the creation of bioactive rather than bioinert scaffold constructs. Relatively rapid biodegradation enables advantageous filling with natural tissue while loss of polymer strength before mass is disadvantageous. Innovative solutions are required to address this and other issues such as the biocompatibility of material surfaces and the use of appropriate scaffold topography and porosity to influence bone cell gene expression.

  17. In vivo study of chitosan-natural nano hydroxyapatite scaffolds for bone tissue regeneration.

    PubMed

    Lee, Jong Seo; Baek, Sang Dae; Venkatesan, Jayachandran; Bhatnagar, Ira; Chang, Hee Kyung; Kim, Hui Taek; Kim, Se-Kwon

    2014-06-01

    Significant development has been achieved with bioceramics and biopolymer scaffolds in the construction of artificial bone. In the present study, we have developed and compared chitosan-micro hydroxyapatite (chitosan-mHA) and chitosan-nano hydroxyapatite (chitosan-nHA) scaffolds as bone graft substitutes. The biocompatibility and cell proliferation of the prepared scaffolds were checked with preosteoblast (MC3T3-E1) cells. Total Volume (TV), bone volume (BV), bone surface (BS), trabecular thickness (Tb.Th), trabecular number (Tb.N) and trabecular separation (Tb.Sp) were found to be higher in chitosan-nHA than chitosan-mHA scaffold. Hence, we suggest that chitosan-nHA scaffold could be a promising biomaterial for bone tissue engineering. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Substitute Solutions.

    ERIC Educational Resources Information Center

    Jones, Kevin R.; Hawkins, Amber

    2000-01-01

    In summer 1999, a group of Park City, Utah, school administrators, personnel directors, human-resource specialists, and substitute teacher coordinators brainstormed on improving the recruitment, training, and retention of substitute teachers. Providing effective preservice and on-the-job training and professional recognition are key suggestions.…

  19. Skin Substitutes

    PubMed Central

    Howe, Nicole; Cohen, George

    2014-01-01

    In a relatively short timespan, a wealth of new skin substitutes made of synthetic and biologically derived materials have arisen for the purpose of wound healing of various etiologies. This review article focuses on providing an overview of skin substitutes including their indications, contraindications, benefits, and limitations. The result of this overview was an appreciation of the vast array of options available for clinicians, many of which did not exist a short time ago. Yet, despite the rapid expansion this field has undergone, no ideal skin substitute is currently available. More research in the field of skin substitutes and wound healing is required not only for the development of new products made of increasingly complex biomolecular material, but also to compare the existing skin substitutes. PMID:25371771

  20. A histological study of non-ceramic hydroxyapatite as a bone graft substitute material in the vertical bone augmentation of the posterior mandible using an interpositional inlay technique: A split mouth evaluation.

    PubMed

    Bechara, Karen; Dottore, Alexandre M; Kawakami, Paulo Y; Gehrke, Sergio A; Coelho, Paulo G; Piattelli, Adriano; Iezzi, Giovanna; Shibli, Jamil Awad

    2015-11-01

    The aim of this study was to compare the influence of graft material (non-ceramic hydroxyapatite versus autologous bone) on bone behaviour and perform a resonance frequency analysis of implants placed in augmented sites to evaluate stability. For this study, 11 patients with bilateral edentulous areas in the mandibular posterior region were selected. Alveolar augmentation osteotomies were bilaterally (split mouth design) performed. In one hemiarch, the space generated by the osteotomy was grafted with an interpositional intra-oral autologous bone graft (control group). In the other hemiarch, the space generated by the osteotomy was grafted with an interpositional non-ceramic hydroxyapatite (ncHA) (test group). The groups were randomized. After 6 months of healing, a bone sample was retrieved from each side for histological evaluation using a trephine drill that was 2-mm in internal diameter. The implant stability quotient (ISQ) was measured by the resonance frequency immediately following implant placement at baseline and after 6 months of follow-up. Good incorporation of the graft was observed in both groups; however, in the test group, a residual-grafted material was observed. Bone density and marrow spaces were similar between groups. Correlations between the ISQ values and the histometric variables were not observed (p>0.05). The results of this trial suggest that both intra-oral autologous bone and ncHA may be elected as interpositional grafting materials to vertically augment posterior atrophic mandibles. Copyright © 2015 Elsevier GmbH. All rights reserved.

  1. Demineralized Bone Matrix (DBM) as a Bone Void Filler in Lumbar Interbody Fusion: A Prospective Pilot Study of Simultaneous DBM and Autologous Bone Grafts

    PubMed Central

    Kim, Bum-Joon; Kim, Se-Hoon; Lee, Haebin; Lee, Seung-Hwan; Kim, Won-Hyung; Jin, Sung-Won

    2017-01-01

    Objective Solid bone fusion is an essential process in spinal stabilization surgery. Recently, as several minimally invasive spinal surgeries have developed, a need of artificial bone substitutes such as demineralized bone matrix (DBM), has arisen. We investigated the in vivo bone growth rate of DBM as a bone void filler compared to a local autologous bone grafts. Methods From April 2014 to August 2015, 20 patients with a one or two-level spinal stenosis were included. A posterior lumbar interbody fusion using two cages and pedicle screw fixation was performed for every patient, and each cage was packed with autologous local bone and DBM. Clinical outcomes were assessed using the Numeric Rating Scale (NRS) of leg pain and back pain and the Korean Oswestry Disability Index (K-ODI). Clinical outcome parameters and range of motion (ROM) of the operated level were collected preoperatively and at 3 months, 6 months, and 1 year postoperatively. Computed tomography was performed 1 year after fusion surgery and bone growth of the autologous bone grafts and DBM were analyzed by ImageJ software. Results Eighteen patients completed 1 year of follow-up, including 10 men and 8 women, and the mean age was 56.4 (32–71). The operated level ranged from L3/4 to L5/S1. Eleven patients had single level and 7 patients had two-level repairs. The mean back pain NRS improved from 4.61 to 2.78 (p=0.003) and the leg pain NRS improved from 6.89 to 2.39 (p<0.001). The mean K-ODI score also improved from 27.33 to 13.83 (p<0.001). The ROM decreased below 2.0 degrees at the 3-month assessment, and remained less than 2 degrees through the 1 year postoperative assessment. Every local autologous bone graft and DBM packed cage showed bone bridge formation. On the quantitative analysis of bone growth, the autologous bone grafts showed significantly higher bone growth compared to DBM on both coronal and sagittal images (p<0.001 and p=0.028, respectively). Osteoporotic patients showed less bone

  2. A guide to biological skin substitutes.

    PubMed

    Jones, I; Currie, L; Martin, R

    2002-04-01

    The role of artificial skin substitutes in burn surgery and the treatment of chronic wounds is constantly evolving. New products are regularly being produced and approved for clinical use. Studies on existing products clarify their efficacy and effectiveness in different clinical scenarios. This review is aimed at busy clinicians in order to bring them up to date with the latest developments in the field of artificial skin substitutes. It examines the components, structure, performance and comparative costs of the main commercial skin substitutes, and reviews briefly technologies under development that have not yet become widely available. Copyright 2002 The British Association of Plastic Surgeons.

  3. Effect of Alendronate with β – TCP Bone Substitute in Surgical Therapy of Periodontal Intra-Osseous Defects: A Randomized Controlled Clinical Trial

    PubMed Central

    Ravi, Vishali; Subbaraya, Dwijendra Kocherlakota; Prasanna, Jammula Surya; Panthula, Veerendranath Reddy; Koduganti, Rekha Rani

    2016-01-01

    Introduction Alendronate (ALN), an aminobisphosphonate, inhibits osteoclastic bone resorption and also stimulates osteogenesis. Beta-Tricalcium Phosphate (β-TCP) is an osteoconductive graft material which provides a scaffold for bone formation and also a widely used drug delivery vehicle for growth factors and antibiotics. Drug delivery vehicles, like β-TCP, improve the potency of the drugs by specific local site delivery of the drug, optimal release characteristics and easy handling. Aim The aim of the this study was to evaluate the bone formation potential of 400μg ALN delivered in β-TCP in the treatment of periodontal intra-osseous defects. Materials and Methods Thirty patients with periodontal defects were randomly assigned to 400μg ALN + β-TCP + Saline (test) group and β-TCP + Saline (active-control) group. Clinical parameters like Clinical Attachment Level (CAL) gain, Probing Depth (PD) reduction, post-operative Gingival Recession (GR) were assessed from the baseline, 3 months and 6 months recordings. Radiographic parameters like Linear Bone Growth (LBG), Percentage Bone Fill (%BF), and change in alveolar crest height (ACH) were assessed from baseline and 6 months radiographs. Results Mean measurements in the ALN test group for CAL gain (3.4 ± 0.74 mm), PD reduction (4.33 ± 0.82 mm), LBG (2.88 ± 0.88 mm), and %BF (51.98 ± 15.84%) were significantly greater with a p-value <0.05 compared to the mean measurements of CAL gain (2.20 ± 0.86 mm), PD reduction (3.20 ± 1.15 mm), LBG (1.70 ± 0.39 mm), and %BF (30.35 ± 6.88%) of the control group. There was mild alveolar crestal apposition (0.32 ± 0.68 mm) in the ALN test group and mild alveolar crestal resorption (-0.24 ± 0.40 mm) in the control group. Conclusion 400μg ALN combined with β-TCP bone graft material was effective in improving soft tissue parameters, inhibiting alveolar crestal resorption and enhancing bone formation, compared to β-TCP alone. PMID:27656552

  4. Genotoxicity effect, antioxidant and biomechanical correlation: experimental study of agarose-chitosan bone graft substitute in New Zealand white rabbit model.

    PubMed

    Jebahi, Samira; Ben Saleh, Ghada; Saoudi, Mongi; Besaleh, Salma; Oudadesse, Hassane; Mhadbi, Moufida; Rebai, Tarek; Keskes, Hassib; El Feki, Abdelfattah

    2014-08-01

    Bone loss associated with skeletal trauma or metabolic diseases often requires bone grafting. In such situations, a biomaterial is necessary for migrated cells to produce new tissue. In this study, agarose-chitosan was implanted in the femoral condyle of New Zealand White rabbits that were divided into three groups: Group I was used as control; Groups II and III were used as implanted tissue with agarose-chitosan and presenting empty defects, respectively. This study evaluated the agarose-chitosan biocompatibility by determining the in vivo genotoxicity, oxidative stress balance that correlated with the hardness mechanical property. Moreover, the histopathological and quantitative elements analyzed by using inductively coupled plasma optical emission spectrometry were determined. After 30 days of implantation, the in vivo analysis of genotoxicity showed that agarose-chitosan did not induce chromosome aberration or micronucleus damage. A significant decrease in thiobarbituric and acid-reactive substance was observed after agarose-chitosan implantation in the bone tissue. Superoxide dismutase, catalase and glutathione peroxidase were significantly enhanced in agarose-chitosan-treated group compared with that of control group. A negative correlation coefficient of the mechanical property with malonyldialdehyde level was detected (R = -0.998). The histological study exhibited a significantly increased angiogenesis and newly formed tissue. No presence of inflammatory process, necrotic or fibrous tissue was detected. Major and trace elements such as Ca, P, Zn, Mg and Fe were increased significantly in the newly formed bone. These findings show that agarose-chitosan biomaterial implantation might be effective for treating trauma and bone regeneration.

  5. Artificial Limbs

    MedlinePlus

    ... you are missing an arm or leg, an artificial limb can sometimes replace it. The device, which is ... activities such as walking, eating, or dressing. Some artificial limbs let you function nearly as well as before.

  6. Artificial Intelligence.

    ERIC Educational Resources Information Center

    Waltz, David L.

    1982-01-01

    Describes kinds of results achieved by computer programs in artificial intelligence. Topics discussed include heuristic searches, artificial intelligence/psychology, planning program, backward chaining, learning (focusing on Winograd's blocks to explore learning strategies), concept learning, constraint propagation, language understanding…

  7. Genetic regulation of bone mass: from bone density to bone strength.

    PubMed

    Langman, Craig B

    2005-03-01

    Osteoporosis is a common disease characterized in adults by diminished bone density. Bone is an organ that evolves and grows throughout life, and establishing optimal bone density in childhood and adolescence serves to buffer bone loss later in life. Bone density, a measurable entity, is the clinical substitute for bone strength, or the ability to defend against fracture. Chronic diseases may adversely affect optimal peak bone density. Bone density is under genetic control, as revealed by three lines of investigations. These include (1) the finding of quantitative trait loci for bone density, (2) the finding that specific mutations in genes that are important in the development of osteoblast or osteoclast lineages alter bone density, and (3) the linkeage of known polymorphisms for genes involved in mineral homeostasis to bone density and/or fracture. Future therapeutics for improving peak bone density or delaying bone loss later in life may take advantage of the genetic nature of bone density development.

  8. Collagen for bone tissue regeneration.

    PubMed

    Ferreira, Ana Marina; Gentile, Piergiorgio; Chiono, Valeria; Ciardelli, Gianluca

    2012-09-01

    In the last decades, increased knowledge about the organization, structure and properties of collagen (particularly concerning interactions between cells and collagen-based materials) has inspired scientists and engineers to design innovative collagen-based biomaterials and to develop novel tissue-engineering products. The design of resorbable collagen-based medical implants requires understanding the tissue/organ anatomy and biological function as well as the role of collagen's physicochemical properties and structure in tissue/organ regeneration. Bone is a complex tissue that plays a critical role in diverse metabolic processes mediated by calcium delivery as well as in hematopoiesis whilst maintaining skeleton strength. A wide variety of collagen-based scaffolds have been proposed for different tissue engineering applications. These scaffolds are designed to promote a biological response, such as cell interaction, and to work as artificial biomimetic extracellular matrices that guide tissue regeneration. This paper critically reviews the current understanding of the complex hierarchical structure and properties of native collagen molecules, and describes the scientific challenge of manufacturing collagen-based materials with suitable properties and shapes for specific biomedical applications, with special emphasis on bone tissue engineering. The analysis of the state of the art in the field reveals the presence of innovative techniques for scaffold and material manufacturing that are currently opening the way to the preparation of biomimetic substrates that modulate cell interaction for improved substitution, restoration, retention or enhancement of bone tissue function.

  9. Patient-Derived Human Induced Pluripotent Stem Cells From Gingival Fibroblasts Composited With Defined Nanohydroxyapatite/Chitosan/Gelatin Porous Scaffolds as Potential Bone Graft Substitutes

    PubMed Central

    Ji, Jun; Tong, Xin; Huang, Xiaofeng; Zhang, Junfeng

    2016-01-01

    Human embryonic stem cells and adult stem cells have always been the cell source for bone tissue engineering. However, their limitations are obvious, including ethical concerns and/or a short lifespan. The use of human induced pluripotent stem cells (hiPSCs) could avoid these problems. Nanohydroxyapatite (nHA) is an important component of natural bone and bone tissue engineering scaffolds. However, its regulation on osteogenic differentiation with hiPSCs from human gingival fibroblasts (hGFs) is unknown. The purpose of the present study was to investigate the osteogenic differentiation of hiPSCs from patient-derived hGFs regulated by nHA/chitosan/gelatin (HCG) scaffolds with different nHA ratios, such as HCG-111 (1 wt/vol% nHA) and HCG-311 (3 wt/vol% nHA). First, hGFs were reprogrammed into hiPSCs, which have enhanced osteogenic differentiation capability. Second, HCG-111 and HCG-311 scaffolds were successfully synthesized. Finally, hiPSC/HCG complexes were cultured in vitro or subcutaneously transplanted into immunocompromised mice in vivo. The osteogenic differentiation effects of two types of HCG scaffolds on hiPSCs were assessed for up to 12 weeks. The results showed that HCG-311 increased osteogenic-related gene expression of hiPSC