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Lun DX, Li SY, Li NN, Mou LM, Li HQ, Zhu WP, Li HF, Hu YC. Limitations and modifications in the clinical application of calcium sulfate. Front Surg 2024; 11:1278421. [PMID: 38486794 PMCID: PMC10937423 DOI: 10.3389/fsurg.2024.1278421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/29/2024] [Indexed: 03/17/2024] Open
Abstract
Calcium sulfate and calcium sulfate-based biomaterials have been widely used in non-load-bearing bone defects for hundreds of years due to their superior biocompatibility, biodegradability, and non-toxicity. However, lower compressive strength and rapid degradation rate are the main limitations in clinical applications. Excessive absorption causes a sharp increase in sulfate ion and calcium ion concentrations around the bone defect site, resulting in delayed wound healing and hypercalcemia. In addition, the space between calcium sulfate and the host bone, resulting from excessively rapid absorption, has adverse effects on bone healing or fusion techniques. This issue has been recognized and addressed. The lack of sufficient mechanical strength makes it challenging to use calcium sulfate and calcium sulfate-based biomaterials in load-bearing areas. To overcome these defects, the introduction of various inorganic additives, such as calcium carbonate, calcium phosphate, and calcium silicate, into calcium sulfate is an effective measure. Inorganic materials with different physical and chemical properties can greatly improve the properties of calcium sulfate composites. For example, the hydrolysis products of calcium carbonate are alkaline substances that can buffer the acidic environment caused by the degradation of calcium sulfate; calcium phosphate has poor degradation, which can effectively avoid the excessive absorption of calcium sulfate; and calcium silicate can promote the compressive strength and stimulate new bone formation. The purpose of this review is to review the poor properties of calcium sulfate and its complications in clinical application and to explore the effect of various inorganic additives on the physicochemical properties and biological properties of calcium sulfate.
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Affiliation(s)
- Deng-xing Lun
- Department of Spinal Degeneration and Oncology, Weifang People’s Hospital, Weifang City, Shandong, China
| | - Si-ying Li
- Department of Spinal Degeneration and Oncology, Weifang People’s Hospital, Weifang City, Shandong, China
| | - Nian-nian Li
- Department of Spinal Degeneration and Oncology, Weifang People’s Hospital, Weifang City, Shandong, China
| | - Le-ming Mou
- Department of Spinal Degeneration and Oncology, Weifang People’s Hospital, Weifang City, Shandong, China
| | - Hui-quan Li
- Department of Spinal Degeneration and Oncology, Weifang People’s Hospital, Weifang City, Shandong, China
| | - Wan-ping Zhu
- Department of Spinal Degeneration and Oncology, Weifang People’s Hospital, Weifang City, Shandong, China
| | - Hong-fei Li
- Department of Spinal Degeneration and Oncology, Weifang People’s Hospital, Weifang City, Shandong, China
| | - Yong-cheng Hu
- Department of Bone Oncology, Tianjin Hospital, Tianjin, China
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Jacob RGM, Ervolino da Silva AC, Chaushu L, Lang NP, Borges Duailibe de Deus C, Botticelli D, Rangel Garcia Júnior I. Evaluation of Two Configurations of Hydroxyapatite and Beta-Tricalcium Phosphate in Sinus Grafts with Simultaneous Implant Installation: An Experimental Study in Rabbits. Dent J (Basel) 2023; 11:121. [PMID: 37232771 PMCID: PMC10217008 DOI: 10.3390/dj11050121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/20/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND This study aimed to evaluate peri-implant bone formation in rabbits after sinus grafting mediated by hydroxyapatite and beta-tricalcium phosphate (HA + β-TCP) in granule or paste configurations, concomitant with immediate implant installation. MATERIAL & METHODS Thirty-four rabbit maxillary sinuses were grafted with HA + β-TCP, half of which were applied in a granule and half in a paste composition. Implant placement was performed simultaneously. At 7 and 40 days postoperatively, the animals were euthanized, and samples were prepared for tomographic, microtomographic, histological, histometric (hematoxylin and eosin staining, HE), and immunohistochemical (labeling of transcription factor Runx-2 [RUNX2], vascular endothelial growth factor [VEGF], osteocalcin [OCN], and tartrate-resistant acid phosphatase [TRAP]) analysis. Implant removal torque was also measured. RESULTS On tomography, maintenance of sinus membrane integrity was observed in both the groups. Higher values of morphometric parameters evaluated by micro-CT were found in the "paste group" after seven days. At 40 days, there were no significant differences between the groups in most of the microtomographic parameters evaluated. In histological sections stained with HE, a higher percentage of newly formed bone was observed in the "granule group" after 40 days. Similar positive immunolabeling was observed for both RUNX2 and OCN in both the experimental groups. TRAP immunolabeling was similar in both groups as well. VEGF labeling increased in the "granule group", indicating a higher osteoconductive potential in this biomaterial. Similar removal torque values were observed in both groups. Thus, the two HA + β-TCP configurations showed similar healing patterns of simultaneously installed implants adjacent to sinus floor elevation. However, significantly higher bone values were observed for the "granule configuration". CONCLUSIONS The HA + β-TCP granules and paste presentations showed favorable long-term healing results, with bone formation in similar quantities and quality adjacent to the implants.
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Affiliation(s)
- Ricardo Garcia Mureb Jacob
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil
| | - Ana Cláudia Ervolino da Silva
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
| | - Liat Chaushu
- Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dentistry, Tel Aviv University, Tel Aviv 69978, Israel;
| | - Niklaus Peter Lang
- School of Dental Medicine, University of Berne, CH-3010 Berne, Switzerland
| | - Ciro Borges Duailibe de Deus
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil
| | | | - Idelmo Rangel Garcia Júnior
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
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3
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Batista Campos L, Kurihara MNL, Santos INM, Dos Reis FB, Salles MJ. In vitro elution characteristics of antibiotic-loaded polymethylmethacrylate cement and a calcium sulfate bone substitute using staphylococci isolated from orthopedic implant-associated infections. J Biomed Mater Res B Appl Biomater 2023; 111:1318-1327. [PMID: 36779478 DOI: 10.1002/jbm.b.35235] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/17/2023] [Accepted: 01/30/2023] [Indexed: 02/14/2023]
Abstract
Polymethylmethacrylate (PMMA) remains the gold standard antibiotic carrier in the management of osteomyelitis. However, biodegradable ceramic carriers may exhibit more efficient antibiotic elution properties. Through zone of inhibition (ZOI) testing and biofilm killing assays, we assessed the in vitro elution efficacy of vancomycin released from calcium sulfate (PG-CSH) and PMMA beads as carriers on clinical strains of Staphylococcus aureus and Staphylococcus epidermidis, which were isolated from sonication fluid of orthopedic implant-associated infections. Overall, vancomycin-loaded PMMA and PG-CSH beads showed potency (ZOI above 4 cm2 ) for up to 14 days against ATCC and clinical strains. Vancomycin-loaded PG-CSH beads displayed higher rates, exhibited a more stable antibiotic elution, had greater impacts on bacterial colony-forming unit counts and produced higher ZOIs; additionally, statistically significant differences (Student's t test) were observed in different time sets during the experiment. In the biofilm killing assay, PG-CSH loaded with vancomycin resulted in more bacterial deaths. In conclusion, in the present study, both PG-CSH and PMMA beads acted as good carriers, but greater antimicrobial elution and biofilm bacterial killing were observed with PG-CSH than PMMA. Future in vitro research should focus on testing other difficult-to-treat clinical strains, including multidrug resistant coagulase-negative staphylococci and Gram-negative bacilli.
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Affiliation(s)
- Laura Batista Campos
- Laboratório Especial de Microbiologia (LEMC), Department of Internal Medicine, Division of infectious Diseases, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Mariana Neri Lucas Kurihara
- Laboratório Especial de Microbiologia (LEMC), Department of Internal Medicine, Division of infectious Diseases, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Ingrid Nayara Marcelino Santos
- Laboratório Especial de Microbiologia (LEMC), Department of Internal Medicine, Division of infectious Diseases, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Fernando Baldy Dos Reis
- Department of Orthopedic, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Mauro José Salles
- Laboratório Especial de Microbiologia (LEMC), Department of Internal Medicine, Division of infectious Diseases, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Hospital São Paulo, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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4
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Banche-Niclot F, Corvaglia I, Cavalera C, Boggio E, Gigliotti CL, Dianzani U, Tzagiollari A, Dunne N, Manca A, Fiorilli S, Vitale-Brovarone C. Optimization of an Injectable, Resorbable, Bioactive Cement Able to Release the Anti-Osteoclastogenic Biomolecule ICOS-Fc for the Treatment of Osteoporotic Vertebral Compression Fractures. Biomolecules 2023; 13:biom13010094. [PMID: 36671479 PMCID: PMC9855932 DOI: 10.3390/biom13010094] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 01/05/2023] Open
Abstract
Vertebral compression fractures are typical of osteoporosis and their treatment can require the injection of a cement through a minimally invasive procedure to restore vertebral body height. This study reports the development of an injectable calcium sulphate-based composite cement able to stimulate bone regeneration while inhibiting osteoclast bone resorption. To this aim, different types of strontium-containing mesoporous glass particles (Sr-MBG) were added to calcium sulphate powder to impart a pro-osteogenic effect, and the influence of their size and textural features on the cement properties was investigated. Anti-osteoclastogenic properties were conferred by incorporating into poly(lactic-co-glycolic)acid (PLGA) nanoparticles, a recombinant protein able to inhibit osteoclast activity (i.e., ICOS-Fc). Radiopaque zirconia nanoparticles (ZrO2) were also added to the formulation to visualize the cement injection under fluoroscopy. The measured cement setting times were suitable for the clinical practice, and static mechanical testing determined a compressive strength of ca. 8 MPa, comparable to that of human vertebral bodies. In vitro release experiments indicated a sustained release of ICOS-Fc and Sr2+ ions up to 28 days. Overall, the developed cement is promising for the treatment of vertebral compression fractures and has the potential to stimulate bone regeneration while releasing a biomolecule able to limit bone resorption.
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Affiliation(s)
- Federica Banche-Niclot
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca Degli Abruzzi 24, 10129 Torino, Italy
| | - Ilaria Corvaglia
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca Degli Abruzzi 24, 10129 Torino, Italy
| | - Caterina Cavalera
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca Degli Abruzzi 24, 10129 Torino, Italy
| | - Elena Boggio
- NOVAICOS s.r.l.s., Via Amico Canobio 4/6, 28100 Novara, Italy
- Department of Health Sciences, Università del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
| | - Casimiro Luca Gigliotti
- NOVAICOS s.r.l.s., Via Amico Canobio 4/6, 28100 Novara, Italy
- Department of Health Sciences, Università del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
| | - Umberto Dianzani
- Department of Health Sciences, Università del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
| | - Antzela Tzagiollari
- Centre for Medical Engineering Research, School of Mechanical and Manufacturing Engineering, Dublin City University, D09 NA55 Dublin, Ireland
- Biodesign Europe, Dublin City University, D09 NA55 Dublin, Ireland
| | - Nicholas Dunne
- Centre for Medical Engineering Research, School of Mechanical and Manufacturing Engineering, Dublin City University, D09 NA55 Dublin, Ireland
- Biodesign Europe, Dublin City University, D09 NA55 Dublin, Ireland
| | - Antonio Manca
- Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, 10060 Torino, Italy
| | - Sonia Fiorilli
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca Degli Abruzzi 24, 10129 Torino, Italy
- National Interuniversity Consortium of Materials Science and Technology, RU Politecnico di Torino, 50121 Firenze, Italy
| | - Chiara Vitale-Brovarone
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca Degli Abruzzi 24, 10129 Torino, Italy
- National Interuniversity Consortium of Materials Science and Technology, RU Politecnico di Torino, 50121 Firenze, Italy
- Correspondence:
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Flanagan D. Autogenous Dentin With Calcium Sulfate as Graft Material: A Case Series. J ORAL IMPLANTOL 2021; 48:285-294. [PMID: 34170327 DOI: 10.1563/aaid-joi-d-20-00309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
There have been recent reports of successful use of fragmented autogenous dentin being used as a graft material in implant dentistry. This may reduce morbidity and the need for a second donor ste or for the use of alloplasts or allografts. This article discusses the background, preparation and use of autogenous dentin as an oral osseous graft material. A series of cases where autogenous dentin is used to graft immediate dental implant sites is presented. After 21 months one case biopsy showed only bone and no remnant dentin. Pulverized autogenous dentin may be an appropriate graft material in implant dentistry.
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Affiliation(s)
- Dennis Flanagan
- Connecticut Dental Groups Pres n/a 1671 West Main St UNITED STATES Willimantic CT 06226 860-445-2757 860-445-9765 Connecticut Dental Groups
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6
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Kharouf N, Mancino D, Zghal J, Helle S, Jmal H, Lenertz M, Viart N, Bahlouli N, Meyer F, Haikel Y, Ball V. Dual role of tannic acid and pyrogallol incorporated in plaster of Paris: Morphology modification and release for antimicrobial properties. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 127:112209. [PMID: 34225861 DOI: 10.1016/j.msec.2021.112209] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/01/2021] [Accepted: 05/22/2021] [Indexed: 12/17/2022]
Abstract
The design of bioactive plasters is of major interest for the amelioration of dental and bone cements. In this article, a one pot and environmentally friendly strategy based on the addition of a cheap polyphenol-tannic acid (TA) or the main phenolic constituent of TA, namely pyrogallol (PY)- able to interact with calcium sulfate is proposed. Tannic acid and pyrogallol not only modify the morphology of the obtained plaster+TA/PY composites but a part of it is released and provides strong-up to twenty fold- antibacterial effect against Staphylococcus aureus. It is shown that the higher antibacterial efficiency of PY is related to a greater release compared to TA even if in solution the antibacterial effect of PY is lower than that of TA when reported on the basis of the molar concentration in PY units.
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Affiliation(s)
- Naji Kharouf
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Sainte Elisabeth, 67000 Strasbourg, France; Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1121, 11 rue Humann, 67085 Strasbourg Cedex, France
| | - Davide Mancino
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Sainte Elisabeth, 67000 Strasbourg, France; Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1121, 11 rue Humann, 67085 Strasbourg Cedex, France
| | - Jihed Zghal
- ICube Laboratory, UMR 7357 CNRS, Mechanics Department, University of Strasbourg, 6700 Strasbourg, France; Laboratoire Energetique Mecanique Electromagnetisme, University of Paris Ouest, 50 rue de Sèvres, 92410 Ville d'Avray, France
| | - Sophie Helle
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1121, 11 rue Humann, 67085 Strasbourg Cedex, France
| | - Hamdi Jmal
- ICube Laboratory, UMR 7357 CNRS, Mechanics Department, University of Strasbourg, 6700 Strasbourg, France
| | - Marc Lenertz
- Institut de Physique et Chimie des Matériaux de Strasbourg, CNRS, Université de Strasbourg, 23 rue du Lœss, F-67034 Strasbourg, France
| | - Nathalie Viart
- Institut de Physique et Chimie des Matériaux de Strasbourg, CNRS, Université de Strasbourg, 23 rue du Lœss, F-67034 Strasbourg, France
| | - Nadia Bahlouli
- ICube Laboratory, UMR 7357 CNRS, Mechanics Department, University of Strasbourg, 6700 Strasbourg, France
| | - Florent Meyer
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Sainte Elisabeth, 67000 Strasbourg, France; Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1121, 11 rue Humann, 67085 Strasbourg Cedex, France
| | - Youssef Haikel
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Sainte Elisabeth, 67000 Strasbourg, France; Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1121, 11 rue Humann, 67085 Strasbourg Cedex, France
| | - Vincent Ball
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Sainte Elisabeth, 67000 Strasbourg, France; Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1121, 11 rue Humann, 67085 Strasbourg Cedex, France.
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7
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Ene R, Nica M, Ene D, Cursaru A, Cirstoiu C. Review of calcium-sulphate-based ceramics and synthetic bone substitutes used for antibiotic delivery in PJI and osteomyelitis treatment. EFORT Open Rev 2021; 6:297-304. [PMID: 34150324 PMCID: PMC8183146 DOI: 10.1302/2058-5241.6.200083] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Infection in orthopaedic and trauma surgery remains a destructive complication with particularly challenging diagnosis and treatment due to bacterial antibiotic resistance and biofilm formation. Along with surgical debridement and systemic antibiotics, an important type of adjuvant therapy is local antibiotic delivery, with the purpose of eliminating bacterial colonization and biofilm development. Calcium sulphate, as a synthetic absorbable biomaterial used for local antibiotic delivery, has experienced an increasing popularity during the last decade, with multiple promoted advantages such as predictable antibiotic elution kinetics, complete and quick biodegradation, good biocompatibility, and limited associated complications. A series of commercially available antibiotic-delivery systems based on calcium sulphate are under investigation and in clinical use, with different presentations, compositions, and application techniques. The current article presents the main available calcium-sulphate-based products and the existing data about the clinical and preclinical research results, stemming from their implementation as local antibiotic carriers for surgical site and implant-associated infections treatment and prevention.
Cite this article: EFORT Open Rev 2021;6:297-304. DOI: 10.1302/2058-5241.6.200083
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Affiliation(s)
- Razvan Ene
- Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania.,Bucharest Emergency Clinical Hospital, Romania
| | - Mihai Nica
- Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania.,University Emergency Hospital Bucharest, Romania
| | - Dragos Ene
- Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania.,Bucharest Emergency Clinical Hospital, Romania
| | - Adrian Cursaru
- Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania.,University Emergency Hospital Bucharest, Romania
| | - Catalin Cirstoiu
- Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania.,University Emergency Hospital Bucharest, Romania
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Calcium Phosphate Modified with Silicon vs. Bovine Hydroxyapatite for Alveolar Ridge Preservation: Densitometric Evaluation, Morphological Changes and Histomorphometric Study. MATERIALS 2021; 14:ma14040940. [PMID: 33671155 PMCID: PMC7922764 DOI: 10.3390/ma14040940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/13/2021] [Accepted: 02/15/2021] [Indexed: 01/07/2023]
Abstract
After tooth extraction, the alveolar bone undergoes a physiological resorption that may compromise the future placement of the implant in its ideal position. This study evaluated bone density, morphological changes, and histomorphometric results undergone by alveolar bone after applying a new biomaterial composed of calcium phosphate modified with silicon (CAPO-Si) compared with hydroxyapatite of bovine origin (BHA). Alveolar ridge preservation (ARP) was performed in 24 alveoli, divided into a test group filled with CAPO-Si and a control group filled with BHA. Three months later, the mineral bone density obtained by the biomaterials, horizontal and vertical bone loss, the degree of alveolar corticalization, and histomorphometric results were evaluated. Both biomaterials presented similar behavior in terms of densitometric results, vertical bone loss, and degree of alveolar corticalization. Alveoli treated with CAPO-Si showed less horizontal bone loss in comparison with alveoli treated with BHA (0.99 ± 0.2 mm vs. 1.3 ± 0.3 mm), with statistically significant difference (p = 0.017). Histomorphometric results showed greater bone neoformation in the test group than the control group (23 ± 15% vs. 11 ± 7%) (p = 0.039) and less residual biomaterial (5 ± 10% vs. 17 ± 13%) (p = 0.043) with statistically significant differences. In conclusion, the ARP technique obtains better results with CAPO-Si than with BHA.
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9
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Dewi AH, Yulianto DK, Siswomihardjo W, Rochmadi R, Ana ID. Effect of Dehydrothermal Treatment on the Mechanical Properties and Biocompatibility of Plaster of Paris–CaCO 3 Hydrogel Loaded With Cinnamaldehyde for Biomedical Purposes. Nat Prod Commun 2021. [DOI: 10.1177/1934578x20984609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
CaCO3 hydrogel incorporation into Plaster of Paris (POP) formulations decreased the resorption rate of the POP after implantation in the body. Although an inflammatory process is required as part of wound healing, the accumulation and activation of inflammatory cells in the POP–hydrogel CaCO3 implant area needs to be controlled. Therefore, cinnamaldehyde, as an anti-inflammatory agent with a unique α, β-unsaturated aldehyde, was incorporated into the CaCO3 hydrogel. During the incorporation, both the lipophilic and hydrophilic sides of the cinnamaldehyde molecule can influence the physical and mechanical properties of the CaCO3 hydrogel, in which mechanical properties of a tissue engineering scaffold are important to fine tune cellular activity during implantation. On the other hand, as a 3-dimensional polymeric structure, crosslinking is needed for the CaCO3 hydrogel to stabilize and increase its molecular weight for better mechanical strength, and more resistance to heat, wear, and solvent attack. For that purpose, dehydrothermal treatment (DHT) was applied to the crosslink hydrogel system as a favorable crosslinking method to avoid the use of a chemical agent. In this study, 3 groups of hydrogels of CaCO3, namely DHT crosslinked, loaded with cinnamaldehyde, and loaded with cinnamaldehyde followed by DHT crosslinking were developed before being combined with POP in 50 wt%. To evaluate the effect of DHT to the final POP-cinnamaldehyde-loaded CaCO3 hydrogel properties and biocompatibility, scanning electron microscopy, contact angle, surface roughness, hardness, diametral tensile strength, and in vivo biocompatibility studies were conducted. It was observed that cinnamaldehyde with DHT treatment improved the POP–hydrogel CaCO3 properties and had good biocompatibility. Thus, POP-cinnamaldehyde-loaded CaCO3 hydrogel can be a promising bone substitute containing an anti-inflammatory agent.
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Affiliation(s)
- Anne Handrini Dewi
- Dental Biomedical Sciences Departement, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Dedy Kusuma Yulianto
- Dental Biomedical Sciences Departement, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Widowati Siswomihardjo
- Dental Biomaterial Department, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Rochmadi Rochmadi
- Chemical Engineering Department, Faculty of Engineering, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ika Dewi Ana
- Dental Biomedical Sciences Departement, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
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10
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Wu IT, Kao PF, Huang YR, Ding SJ. In vitro and in vivo osteogenesis of gelatin-modified calcium silicate cement with washout resistance. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 117:111297. [DOI: 10.1016/j.msec.2020.111297] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 07/04/2020] [Accepted: 07/21/2020] [Indexed: 12/11/2022]
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11
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Bone Healing and Regeneration Potential in Rabbit Cortical Defects Using an Innovative Bioceramic Bone Graft Substitute. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10186239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This study aimed to elucidate the local effect and micro-computed tomographic (μ-CT) assessment following bone implantation of an innovative bioceramic (α-calcium sulfate hemihydrate; α-CSH) on femur lateral condyle cortical bone of rabbit models. The innovative α-CSH bioceramic was synthesized through a green processing technology (microwave irradiation treatment). The bilateral implantation model was performed among 24 New Zealand White rabbits which were divided into three groups based on the type of filling materials: α-CSH, control, and blank. Treatments were performed in defects with 6 mm diameter and 7 mm depth and observed after 2, 4, 8, and 12 weeks. Material reaction and bone formation after implantation were evaluated radiographically and histopathologically. The μ-CT analysis results showed that the degradation of α-CSH and control material was similar at 4 and 8 weeks. The bone volume in the defects indicated the α-CSH increased most in 8 weeks. In histopathological evaluation, the α-CSH group was repaired with lamellar bone and well-grown bone marrow infiltration similar to the control material. Moreover, the α-CSH revealed a faster degradation rate and better healing progress than the control material under the same conditions. Therefore, the α-CSH was confirmed to be useful in promoting osteoconduction and in controlling the resorption rate in bone defects. Further, the innovative α-CSH could be considered as a promising bone substitute for utilization in bone reconstructive therapy in dental and orthopedic fields.
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Physical/Chemical Properties and Resorption Behavior of a Newly Developed Ca/P/S-Based Bone Substitute Material. MATERIALS 2020; 13:ma13163458. [PMID: 32764505 PMCID: PMC7475886 DOI: 10.3390/ma13163458] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/29/2020] [Accepted: 08/02/2020] [Indexed: 12/11/2022]
Abstract
Properly regulating the resorption rate of a resorbable bone implant has long been a great challenge. This study investigates a series of physical/chemical properties, biocompatibility and the behavior of implant resorption and new bone formation of a newly developed Ca/P/S-based bone substitute material (Ezechbone® Granule CBS-400). Experimental results show that CBS-400 is comprised majorly of HA and CSD, with a Ca/P/S atomic ratio of 54.6/39.2/6.2. After immersion in Hank’s solution for 7 days, the overall morphology, shape and integrity of CBS-400 granules remain similar to that of non-immersed samples without showing apparent collapse or disintegration. With immersion time, the pH value continues to increase to 6.55 after 7 days, and 7.08 after 14 days. Cytotoxicity, intracutaneous reactivity and skin sensitization tests demonstrate the good biocompatibility features of CBS-400. Rabbit implantation/histological observations indicate that the implanted granules are intimately bonded to the surrounding new bone at all times. The implant is not merely a degradable bone substitute, but its resorption and the formation of new cancellous bone proceed at the substantially same pace. After implantation for 12 weeks, about 85% of the implant has been resorbed. The newly-formed cancellous bone ratio quickly increases to >40% at 4 weeks, followed by a bone remodeling process toward normal cancellous bone, wherein the new cancellous bone ratio gradually tapers down to about 30% after 12 weeks.
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13
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Robinson TE, Hughes EAB, Bose A, Cornish EA, Teo JY, Eisenstein NM, Grover LM, Cox SC. Filling the Gap: A Correlation between Objective and Subjective Measures of Injectability. Adv Healthc Mater 2020; 9:e1901521. [PMID: 31977153 DOI: 10.1002/adhm.201901521] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/13/2020] [Indexed: 12/20/2022]
Abstract
Various injectable biomaterials are developed for the minimally invasive delivery of therapeutics. Typically, a mechanical tester is used to ascertain the force required to inject these biomaterials through a given syringe-needle system. However, currently there is no method to correlate the force measured in the laboratory to the perceived effort required to perform that injection by the end user. In this article, the injection force (F) for a variety of biomaterials, displaying a range of rheological properties, is compared with the effort scores from a 50 person panel study. The maximum injection force measured at crosshead speed 1 mm s-1 is a good proxy for injection effort, with an R2 of 0.89. This correlation leads to the following conclusions: participants can easily inject 5 mL of substance for F < 12 N; considerable effort is required to inject 5 mL for 12 N < F < 38 N; great effort is required and <5 mL can be injected for 38 N < F < 64 N; and materials are entirely non-injectable for F > 64 N. These values may be used by developers of injectable biomaterials to make decisions about formulations and needle sizes early in the translational process.
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Affiliation(s)
- Thomas E. Robinson
- School of Chemical EngineeringUniversity of Birmingham Edgbaston B15 2TT UK
| | - Erik A. B. Hughes
- School of Chemical EngineeringUniversity of Birmingham Edgbaston B15 2TT UK
| | - Aniruddha Bose
- School of Chemical EngineeringUniversity of Birmingham Edgbaston B15 2TT UK
| | | | - Jun Y. Teo
- School of Chemical EngineeringUniversity of Birmingham Edgbaston B15 2TT UK
| | - Neil M. Eisenstein
- School of Chemical EngineeringUniversity of Birmingham Edgbaston B15 2TT UK
| | - Liam M. Grover
- School of Chemical EngineeringUniversity of Birmingham Edgbaston B15 2TT UK
| | - Sophie C. Cox
- School of Chemical EngineeringUniversity of Birmingham Edgbaston B15 2TT UK
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Meng ZL, Wu ZQ, Shen BX, Li HB, Bian YY, Zeng DL, Fu J, Peng L. Reconstruction of large segmental bone defects in rabbit using the Masquelet technique with α-calcium sulfate hemihydrate. J Orthop Surg Res 2019; 14:192. [PMID: 31242906 PMCID: PMC6595676 DOI: 10.1186/s13018-019-1235-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 06/11/2019] [Indexed: 12/17/2022] Open
Abstract
Background Large segmental bone defects can be repaired using the Masquelet technique in conjunction with autologous cancellous bone (ACB). However, ACB harvesting is severely restricted. α-calcium sulfate hemihydrate (α-CSH) is an outstanding bone substitute due to its easy availability, excellent biocompatibility, biodegradability, and osteoconductivity. However, the resorption rate of α-CSH is too fast to match the rate of new bone formation. The objective of this study was to investigate the bone repair capacity of the Masquelet technique in conjunction with isolated α-CSH or an α-CSH/ACB mix in a rabbit critical-sized defect model. Methods The rabbits (n = 28) were randomized into four groups: sham, isolated α-CSH, α-CSH/ACB mix, and isolated ACB group. A 15-mm critical-sized defect was established in the left radius, followed by filling with polymethyl methacrylate spacer. Six weeks after the first operation, the spacers were removed and the membranous tubes were grafted with isolated α-CSH, isolated ACB, α-CSH/ACB mix, or none. Twelve weeks later, the outcomes were evaluated by manual assessment, radiography, and spiral-CT. The histopathological and morphological changes were examined by H&E staining. The levels of alkaline phosphatase and osteocalcin were analyzed by immunohistochemistry and immunofluorescence staining. Results Our results suggest that the bone repair capacity of the α-CSH/ACB mix group was similar to the isolated ACB group, while the isolated α-CSH group was significantly decreased compared to the isolated ACB group. Conclusion These results highlighted a promising strategy in the healing of large segmental bone defect with the Masquelet technique in conjunction with an α-CSH/ACB mix (1:1, w/w) as they possessed the combined effects of sufficient supply and low resorption.
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Affiliation(s)
- Zhu Long Meng
- Municipal Hospital Affiliated to Medical School of Taizhou University, Taizhou, China.,Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Zi Quan Wu
- Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Bi Xin Shen
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Hong Bo Li
- Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Yang Yang Bian
- Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - De Lu Zeng
- Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Jian Fu
- Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Lei Peng
- Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China.
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15
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Sargolzaie N, Rafiee M, Salari Sedigh H, Zare Mahmoudabadi R, Keshavarz H. Comparison of the effect of hemihydrate calcium sulfate granules and Cerabone on dental socket preservation: An animal experiment. J Dent Res Dent Clin Dent Prospects 2019; 12:238-244. [PMID: 30774788 PMCID: PMC6368944 DOI: 10.15171/joddd.2018.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 11/22/2018] [Indexed: 11/09/2022] Open
Abstract
Background. Early bone loss due to tooth extraction can be significantly reduced by socket preservation. The aim of this study was to compare the in vivo effects of hemihydrate calcium sulfate granules (an alloplastic material) and Cerabone (a bovine-derived xenograft) on socket preservation in dogs. Methods. Six male Mongrel dogs were randomly divided into 2 groups (n=3) for sacrificing and histological evaluation 4 and 8 weeks after a surgery. The second and third premolars on both sides of the lower jaw were extracted surgically. The sockets on one side were filled with Cerabone, and with calcium sulfate on the opposite side. In the slides, the ratio of the area of newly formed bone to the area of the entire cavity, and the ratio of the area of fibrous connective tissue to the area of the entire cavity were measured. The presence of inflammation was also examined. Wilcoxon signed-rank test, Sign test and McNemar test were used for statistical analyses (ɑ=0.05). Results. The means of new bone proportion were 11% and 8% for Cerabone and calcium sulfate, respectively (P=0.58). The means of connective tissue proportion were 29% and 33% for Cerabone and calcium sulfate, respectively (P=0.72). No inflammatory cells were observed in the Cerabone group, although 50% of the samples in the calcium sulfate group showed inflammation (P=0.50). Conclusion. The effects of calcium sulfate and Cerabone on socket preservation in dogs on bone formation, fibrous connective tissue and inflammation levels were not significantly different at 4- and 8-week postoperative intervals.
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Affiliation(s)
- Naser Sargolzaie
- Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Hamideh Salari Sedigh
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran3Department of Clinical Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Reza Zare Mahmoudabadi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.,Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hooman Keshavarz
- Department of Community Oral Health, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.,Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Ji M, Ding Z, Chen H, Peng H, Yan Y. Design of novel organic–inorganic composite bone cements with high compressive strength,
in vitro
bioactivity and cytocompatibility. J Biomed Mater Res B Appl Biomater 2019; 107:2365-2377. [DOI: 10.1002/jbm.b.34330] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/26/2018] [Accepted: 01/13/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Mizhi Ji
- College of Physical Science and TechnologySichuan University Chengdu Sichuan, 610065 China
| | - Zhengwen Ding
- College of Physical Science and TechnologySichuan University Chengdu Sichuan, 610065 China
| | - Hong Chen
- College of Physical Science and TechnologySichuan University Chengdu Sichuan, 610065 China
| | - Haitao Peng
- College of Physical Science and TechnologySichuan University Chengdu Sichuan, 610065 China
| | - Yonggang Yan
- College of Physical Science and TechnologySichuan University Chengdu Sichuan, 610065 China
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17
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Mena‐Álvarez J, Quispe‐López N, Zubizarreta‐Macho Á, Rico‐Romano C, Rodero‐Villanueva R, Fernández‐Aceñero MJ. Histological analysis of different local haemostatic agents used for periapical surgery: An experimental study with Sprague‐Dawley rats. AUST ENDOD J 2019; 45:357-364. [DOI: 10.1111/aej.12332] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Jesús Mena‐Álvarez
- Department of Endodontics. Faculty of Health Sciences Alfonso X el Sabio University. Villanueva de la Cañada Madrid Spain
| | - Norberto Quispe‐López
- Department of Endodontics. Faculty of Health Sciences Alfonso X el Sabio University. Villanueva de la Cañada Madrid Spain
| | - Álvaro Zubizarreta‐Macho
- Department of Endodontics. Faculty of Health Sciences Alfonso X el Sabio University. Villanueva de la Cañada Madrid Spain
| | - Cristina Rico‐Romano
- Department of Endodontics. Faculty of Health Sciences Alfonso X el Sabio University. Villanueva de la Cañada Madrid Spain
| | - Rosa Rodero‐Villanueva
- Servicio de Anatomía Patologica Hospital Clínico San Carlos, Facultad de Medicina, Departamento de Anatomía Patologica, Universidad Complutense de Madrid (UCM), Instituto de Investigacion Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
| | - María Jesús Fernández‐Aceñero
- Servicio de Anatomía Patologica Hospital Clínico San Carlos, Facultad de Medicina, Departamento de Anatomía Patologica, Universidad Complutense de Madrid (UCM), Instituto de Investigacion Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
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18
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Zhou Z, Cunningham E, Lennon A, McCarthy HO, Buchanan F, Dunne N. Development of three-dimensional printing polymer-ceramic scaffolds with enhanced compressive properties and tuneable resorption. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 93:975-986. [PMID: 30274136 DOI: 10.1016/j.msec.2018.08.048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 05/03/2018] [Accepted: 08/21/2018] [Indexed: 01/30/2023]
Abstract
In this study, bone tissue engineered scaffolds fabricated via powder-based 3D printing from hydroxyapatite (HA) and calcium sulphate (CaSO4) powders were investigated. The combination of using a fast resorbing CaSO4 based powder and the relatively slower HA powder represents a promising prospect for tuning the bioresorption of 3D printed (3DP) scaffolds. These properties could then be tailored to coincide with tissue growth rate for different surgical procedures. The manufactured scaffolds were infiltrated with poly(ε‑caprolactone) (PCL). The PCL infiltrated the inter-particle spacing within the 3DP structures due to the nature of a loosely-packed powder bed and also covered the surface of ceramic-based scaffolds. Consequently, the average compressive strength, compressive modulus and toughness increased by 314%, 465% and 867%, respectively. The resorption behaviour of the 3DP scaffolds was characterised in vitro using a high-throughput system that mimicked the physiological environment and dynamic flow conditions relevant to the human body. A rapid release of CaSO4 between Day 0 and 28 was commensurate with a reduction in scaffold mass and compressive properties, as well as an increase in medium absorption. In spite of this, HA particles, connected by PCL fibrils, remained within the microstructure after 56 days resorption under dynamic conditions. Consequently, a high level of structural integrity was maintained within the 3DP scaffold. This study presented a porous PCL-HA-CaSO4 3DP structure with the potential to encourage new tissue growth during the initial stages of implantation and also offering sufficient structural and mechanical support during the bone healing phase.
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Affiliation(s)
- Zuoxin Zhou
- Centre for Additive Manufacturing, Faculty of Engineering, The University of Nottingham, UK
| | - Eoin Cunningham
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, UK
| | - Alex Lennon
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, UK
| | - Helen O McCarthy
- Centre for Medical Engineering Research, School of Mechanical and Manufacturing Engineering, Dublin City University, Dublin 9, Ireland
| | - Fraser Buchanan
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, UK
| | - Nicholas Dunne
- School of Mechanical and Manufacturing Engineering, Dublin City University, Dublin 9, Ireland; Centre for Medical Engineering Research, School of Mechanical and Manufacturing Engineering, Dublin City University, Dublin 9, Ireland; School of Pharmacy, Queen's University Belfast, UK; Trinity Centre for Bioengineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland.
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19
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Influence of magnesium particles and Pluronic F127 on compressive strength and cytocompatibility of nanocomposite injectable and moldable beads for bone regeneration. J Mech Behav Biomed Mater 2018; 88:453-462. [PMID: 30218974 DOI: 10.1016/j.jmbbm.2018.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 08/02/2018] [Accepted: 08/03/2018] [Indexed: 11/22/2022]
Abstract
A novel one-step preparation of magnesium particles and Pluronic F127 incorporated with calcium sulfate hemihydrate (CSH) and nano-hydroxyapatite (nHA) ready to use injectable or moldable beads was developed for bone tissue regeneration applications. The nanocomposite showed setting time less than 15 min, very good injectability (75-85%) and good mechanical strength (52-80 MPa). Samples immersed in SBF showed controlled degradation (40-45% reduction in weight) in 28 days. The nanocomposite bone graft was cytocompatible against MG63 osteosarcoma cells and increased the osteogenic gene expression by 2-3 folds. These results indicate that it can be a potential defect filling biomaterial for bone tissue regeneration at the fracture site.
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20
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Leukel S, Panthöfer M, Mondeshki M, Schärtl W, Plana-Ruiz S, Tremel W. Calcium Sulfate Nanoparticles with Unusual Dispersibility in Organic Solvents for Transparent Film Processing. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2018; 34:7096-7105. [PMID: 29852740 DOI: 10.1021/acs.langmuir.8b00927] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Calcium sulfate is one of the most important construction materials. Today it is employed as high-performance compound in medical applications and cement mixtures. We report a synthesis for calcium sulfate nanoparticles with outstanding dispersibility properties in organic solvents without further functionalization. The nanoparticles (amorphous with small γ-anhydrite crystallites, 5-50 nm particle size) form long-term stable dispersions in acetone without any sign of precipitation. 1H NMR spectroscopic techniques and Fourier-transform infrared spectroscopy (FTIR) reveal absorbed 2-propanol on the particle surfaces that induce the unusual dispersibility. Adding water to the nanoparticle dispersion leads to immediate precipitation. A phase transformation to gypsum via bassanite was monitored by an in situ kinetic FT-IR spectroscopic study and transmission electron microscopy (TEM). The dispersibility in a volatile organic solvent and the crystallization upon contact with water open a broad field of applications for the CaSO4 nanoparticles, e.g., as nanogypsum for coatings or the fabrication of hybrid composites.
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Affiliation(s)
- Sebastian Leukel
- Institut für Anorganische Chemie und Analytische Chemie , Johannes Gutenberg-Universität , Duesbergweg 10-14 , D-55128 Mainz , Germany
- Graduate School Materials Science in Mainz, Staudingerweg 9 , D-55128 Mainz , Germany
| | - Martin Panthöfer
- Institut für Anorganische Chemie und Analytische Chemie , Johannes Gutenberg-Universität , Duesbergweg 10-14 , D-55128 Mainz , Germany
| | - Mihail Mondeshki
- Institut für Anorganische Chemie und Analytische Chemie , Johannes Gutenberg-Universität , Duesbergweg 10-14 , D-55128 Mainz , Germany
| | - Wolfgang Schärtl
- Institut für Physikalische Chemie , Johannes Gutenberg-Universität Mainz , Jakob-Welder-Weg 11-15 , D-55128 Mainz , Germany
| | - Sergi Plana-Ruiz
- Department of Materials and Geoscience , Technische Universität Darmstadt , Petersenstrasse 23 , 64287 Darmstadt , Germany
- LENS, MIND/IN2UB, Department of Electronics and Biomedical Engineering , Universitat de Barcelona , Martí i Franquès 1 , 08028 Barcelona , Catalonia
| | - Wolfgang Tremel
- Institut für Anorganische Chemie und Analytische Chemie , Johannes Gutenberg-Universität , Duesbergweg 10-14 , D-55128 Mainz , Germany
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21
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Knabe C, Adel-Khattab D, Hübner WD, Peters F, Knauf T, Peleska B, Barnewitz D, Genzel A, Kusserow R, Sterzik F, Stiller M, Müller-Mai C. Effect of silicon-doped calcium phosphate bone grafting materials on bone regeneration and osteogenic marker expression after implantation in the ovine scapula. J Biomed Mater Res B Appl Biomater 2018; 107:594-614. [DOI: 10.1002/jbm.b.34153] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 04/01/2018] [Accepted: 04/09/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Christine Knabe
- Department of Experimental Orofacial Medicine; Philipps University Marburg; Marburg Germany
| | - Doaa Adel-Khattab
- Department of Experimental Orofacial Medicine; Philipps University Marburg; Marburg Germany
- Department of Periodontology; Ains Shams University; Cairo Egypt
| | | | | | - Tom Knauf
- Department of Experimental Orofacial Medicine; Philipps University Marburg; Marburg Germany
- Department of Orthopedics and Traumatology; Philipps University Marburg; Marburg Germany
| | - Barbara Peleska
- Department of Prosthodontics, School of Dental Medicine; Philipps University Marburg; Marburg Germany
| | | | - Antje Genzel
- Veterinary Research Center; Bad Langensalza Germany
| | - Roderik Kusserow
- Department of Experimental Orofacial Medicine; Philipps University Marburg; Marburg Germany
| | - Florian Sterzik
- Department of Experimental Orofacial Medicine; Philipps University Marburg; Marburg Germany
| | - Michael Stiller
- Department of Experimental Orofacial Medicine; Philipps University Marburg; Marburg Germany
- Department of Prosthodontics, School of Dental Medicine; Philipps University Marburg; Marburg Germany
| | - Christian Müller-Mai
- Department of Orthopedics and Traumatology; Hospital for Special Surgery; Lünen Germany
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22
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Silva LCFD, Porto GG, Andrade ESDS, Laureano Filho JR. Demineralized bone matrix and calcium-phosphate cement in bone regeneration in rats. Acta Cir Bras 2018; 33:354-361. [DOI: 10.1590/s0102-865020180040000007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 03/12/2018] [Indexed: 01/20/2023] Open
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23
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Hao F, Qin L, Liu J, Chang J, Huan Z, Wu L. Assessment of calcium sulfate hemihydrate-Tricalcium silicate composite for bone healing in a rabbit femoral condyle model. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 88:53-60. [PMID: 29636138 DOI: 10.1016/j.msec.2018.02.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 11/24/2017] [Accepted: 02/28/2018] [Indexed: 11/26/2022]
Abstract
Calcium sulfate or plaster of Paris (POP) is considered as a bone cement with a fast degradation rate, which frequently makes it resorb before the bone defect area is completely filled by new bone. The incorporation of tricalcium silicate (C3S) into POP cement has been proven as a feasible approach to reduce the in vitro degradation rate and improve the in vitro bioactivity of the material. However, the in vivo performance of the POP/C3S composite cement is still unclear. Therefore, the aim of the present study is to assess the biodegradability and osteogenesis of POP/C3S composite cement in comparison with those of POP bone cement. To carry out the in vivo evaluation, POP and POP/C3S cements were implanted into a femoral condyle defect model in rabbits (5 mm diameter × 10 mm length) for 4, 8, and 12 weeks duration. The area of the remaining cement and new bone regeneration in bone defect were investigated and quantitatively measured using radiography, micro-computed tomography, and histological staining. For both cements, no sign of inflammation was observed. POP cement was completely degraded at the 8th week of post-implantation. By contrast, only approximately 50% by volume of POP/C3S composite cement degraded at the 12th week, which allowed a long-term framework for new bone formation. The osteogenic ability of POP/C3S composite cement was significantly superior to that of POP as indicated by the higher mineralization rate and maturity of the newly formed bone around the composite cement. In summary, our findings demonstrated that the in vivo degradation behaviors and osteogenic ability of POP cement could be improved by incorporating C3S in vivo, suggesting that POP/C3S composite cement has potential as a biodegradable cement for bone repair.
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Affiliation(s)
- Fengyu Hao
- School of Stomatology, China Medical University, Shenyang 110001, PR China
| | - Limei Qin
- School of Stomatology, China Medical University, Shenyang 110001, PR China
| | - Jingdong Liu
- School of Stomatology, China Medical University, Shenyang 110001, PR China
| | - Jiang Chang
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, PR China
| | - Zhiguang Huan
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, PR China.
| | - Lin Wu
- School of Stomatology, China Medical University, Shenyang 110001, PR China.
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Pförringer D, Harrasser N, Mühlhofer H, Kiokekli M, Stemberger A, van Griensven M, Lucke M, Burgkart R, Obermeier A. Osteoinduction and -conduction through absorbable bone substitute materials based on calcium sulfate: in vivo biological behavior in a rabbit model. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:17. [PMID: 29318379 DOI: 10.1007/s10856-017-6017-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 12/05/2017] [Indexed: 06/07/2023]
Abstract
Calcium sulfate (CS) can be used as an antibiotically impregnated bone substitute in a variety of clinical constellations. Antibiotically loaded bone substitutes find specific application in orthopedic and trauma surgery to prevent or treat bone infections especially in relation to open bone defects. However, its use as a structural bone graft reveals some concerns due to its fast biodegradation. The addition of calcium carbonate and tripalmitin makes CS formulations more resistant to resorption leaving bone time to form during a prolonged degradation process. The aim of the present study was the evaluation of biocompatibility and degradation properties of newly formulated antibiotically impregnated CS preparations. Three different types of CS bone substitute beads were implanted into the tibial metaphysis of rabbits (CS dihydrate with tripalmitin, containing gentamicin (Group A) or vancomycin (Group B); Group C: tobramycin-loaded CS hemihydrate). Examinations were performed by means of x-ray, micro-computed tomography (micro-CT) and histology after 4, 6, 8 and 12 weeks. Regarding biocompatibility of the formulations, no adverse reactions were observed. Histology showed formation of vital bone cells attached directly to the implanted materials, while no cytotoxic effect in the surrounding of the beads was detected. All CS preparations showed osteogenesis associated to implanted material. Osteoblasts attached directly to the implant surface and revealed osteoid production, osteocytes were found in newly mineralized bone. Group C implants (Osteoset®) were subject to quick degradation within 4 weeks, after 6-8 weeks there were only minor remnants with little osteogenesis demonstrated by histological investigations. Group A implants (Herafill®-G) revealed similar degradation within atleast 12 weeks. In contrast, group B implants (CaSO4-V) were still detectable after 12 weeks with the presence of implant-associated osteogenesis atlatest follow-up. In all of these preparations, giant cells were found during implant degradation on surface and inside of resorption lacunae. None of the analyzed CS preparations triggered contact activation. All implants demonstrated excellent biocompatibility, with implants of Group A and B showing excellent features as osteoconductive and -inductive scaffolds able to improve mechanical stability.
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Affiliation(s)
- D Pförringer
- Klinikum rechts der Isar der Technischen Universität München, Klinik und Poliklinik für Unfallchirurgie, München, Germany.
| | - N Harrasser
- Klinikum rechts der Isar der Technischen Universität München, Klinik für Orthopädie und Sportorthopädie, München, Germany
| | - H Mühlhofer
- Klinikum rechts der Isar der Technischen Universität München, Klinik für Orthopädie und Sportorthopädie, München, Germany
| | - M Kiokekli
- Klinikum rechts der Isar der Technischen Universität München, Klinik für Orthopädie und Sportorthopädie, München, Germany
| | - A Stemberger
- Klinikum rechts der Isar der Technischen Universität München, Klinik für Orthopädie und Sportorthopädie, München, Germany
| | - M van Griensven
- Klinikum rechts der Isar der Technischen Universität München, Klinik und Poliklinik für Unfallchirurgie, München, Germany
| | - M Lucke
- Chirurgisches Klinikum München Süd, München, Germany
| | - R Burgkart
- Klinikum rechts der Isar der Technischen Universität München, Klinik für Orthopädie und Sportorthopädie, München, Germany
| | - A Obermeier
- Klinikum rechts der Isar der Technischen Universität München, Klinik für Orthopädie und Sportorthopädie, München, Germany
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Duan X, Liao HX, Zou HZ, Zhang ZJ, Ye JD, Liao WM. An injectable, biodegradable calcium phosphate cement containing poly lactic-co-glycolic acid as a bone substitute in ex vivo human vertebral compression fracture and rabbit bone defect models. Connect Tissue Res 2018; 59:55-65. [PMID: 28267379 DOI: 10.1080/03008207.2017.1301932] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED Purpose/Aim of the study: To evaluate the biomechanical characteristics and biocompatibility of an injectable, biodegradable calcium phosphate cement (CPC) containing poly lactic-co-glycolic acid (PLGA). MATERIALS AND METHODS A vertebral compression fracture model was established using 20 human cadaveric vertebrae (T11-L3) divided into CPC/PLGA composite versus PMMA groups for biomechanical testing. In addition, 35 New Zealand rabbits were used to evaluate biodegradability and osteoconductive properties of CPC/PLGA using a bone defect model. In vitro cytotoxicity was evaluated by culturing with L929 cells. RESULTS The CPC/PLGA composite effectively restored vertebral biomechanical properties. Compared with controls, the maximum load and compression strength of the CPC/PLGA group were lower, and stiffness was lower after kyphoplasty (all p <.05). Degradation was much slower in the control CPC compared with CPC/PLGA group. The bone tissue percentage in the CPC/PLGA group (44.9 ± 23.7%) was significantly higher compared with control CPC group (25.7 ± 10.9%) (p <.05). The viability of cells cultured on CPC/PLGA was greater than 70% compared with the blanks. CONCLUSIONS Our biodegradable CPC/PLGA composite showed good biomechanical properties, cytocompatibility, and osteoconductivity and may represent an ideal bone substitute for future applications.
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Affiliation(s)
- Xin Duan
- a Department of Orthopedics , The First Affiliated Hospital of Sun Yat-sen University , Guangzhou , China.,b Guangzhou First Municipal People's Hospital , Guangzhou , China
| | - Hong-Xing Liao
- c Division of Joint Surgery, Orthopedics Department , The Meizhou People's Hospital , Meizhou , China
| | - Hua-Zhang Zou
- d Gangwang Hospital , Guangzhou Medical College , Guangzhou , China
| | - Zi-Ji Zhang
- a Department of Orthopedics , The First Affiliated Hospital of Sun Yat-sen University , Guangzhou , China
| | - Jian-Dong Ye
- e Department of Materials Science and Engineering, South China University of Technology , Guangzhou , China
| | - Wei-Ming Liao
- a Department of Orthopedics , The First Affiliated Hospital of Sun Yat-sen University , Guangzhou , China
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Liao JC, Chen WP, Wang H. Treatment of thoracolumbar burst fractures by short-segment pedicle screw fixation using a combination of two additional pedicle screws and vertebroplasty at the level of the fracture: a finite element analysis. BMC Musculoskelet Disord 2017; 18:262. [PMID: 28619021 PMCID: PMC5472982 DOI: 10.1186/s12891-017-1623-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 06/09/2017] [Indexed: 11/10/2022] Open
Abstract
Background Traditional one-above and one-below four-screw posterior short-segment instrumentation is used for unstable thoracolumbar burst fractures. However, this method has a high rate of implant failure and early loss of reduction. The purpose of this study was to use finite element (FE) analysis to determine the effect of treating thoracolumbar burst fractures by short-segment pedicle screw fixation using a combination of two additional pedicle screws and vertebroplasty at the level of the fracture. Methods An intact T11-L1 spine FE model was created from the computed tomography images of a male subject. Four fixation models with posterior fusion devices (pedicle screws, rods, cross-link) were established to simulate an unstable thoracolumbar fracture with different fusion surgeries: short-segment fixation with: 1) a link (S-L); 2) intermediate bilateral screws (S-I); 3) a link and calcium sulfate cement (S-L-C); 4) intermediate bilateral screws and calcium sulfate cement (S-I-C). Different loading conditions (flexion, extension, lateral bending, and axial rotation) were applied on the models and analyzed with a FE package. The range of motion (ROM), and the maximum value and distribution of the implant stress, and the stress in the facet joint, were compared between the intact and fixation models. Results The ROM in flexion, extension, axial rotation, and lateral bending was the smallest in the S-I-C model, followed by the S-I, S-L-C, and S-L models. Maximum von Mises stress values were larger under lateral bending and axial rotation loadings than under flexion and extension loading. High stress was concentrated at the crosslink and rod junctions. Maximal von Mises stress on the superior vertebral body for all loading conditions was larger than that on the inferior vertebral body. The maximal von Mises stress of the pedicle screws during all states of motion were 265.3 MPa in S-L fixation, 192.9 MPa in S-I fixation, 258.4 MPa in S-L-C fixation, and 162.3 MPa in S-I-C fixation. Conclusions Short-segment fixation with two intermediate pedicle screws together with calcium sulfate cement at the fractured vertebrae may provide a stiffer construct and less von Mises stress of the pedicle screws and rods as compared to other types of short-segment fixation.
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Affiliation(s)
- Jen-Chung Liao
- Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Weng-Pin Chen
- Department of Mechanical Engineering, National Taipei University of Technology, 1, Sec. 3, Chung-Hsiao E. Rd, Taipei, 10608, Taiwan.
| | - Hao Wang
- Department of Mechanical Engineering, National Taipei University of Technology, 1, Sec. 3, Chung-Hsiao E. Rd, Taipei, 10608, Taiwan
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Hughes EAB, Grover LM. Characterisation of a novel poly (ether ether ketone)/calcium sulphate composite for bone augmentation. Biomater Res 2017; 21:7. [PMID: 28529763 PMCID: PMC5437598 DOI: 10.1186/s40824-017-0093-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/10/2017] [Indexed: 11/16/2022] Open
Abstract
Background Calcium sulphate (CS) has been used in bone grafting since the 1800s. It has not replaced autograft as the gold standard, however, since its dissolution occurs rapidly in bodily fluids, meaning that the material cannot support long-term bone growth. Here, the polymer poly (ether ether ketone) (PEEK) was used to slow dissolution in in vitro physiological environments and augment the mechanical properties of the material. Methods PEEK/CS specimens were fabricated by combining powders of PEEK and CS with water, resulting in a hardening paste. To enhance physical interactions between phases, cylindrical specimens were heat-treated to melt and fuse the PEEK. Following analysis of physical and chemical interactions by SEM and FT-IR respectively, dynamic ageing in PBS and compression testing was undertaken to measure how the PEEK influenced the mechanical properties of the final parts. Changes in structure and chemistry were determined using helium pycnometry, SEM and analysis of powder XRD patterns. Results Powders of PEEK and CS hemihydrate (CSH) (CaSO4.0.5H2O) were combined with PEEK at 0 wt%, 2.5 wt%, 20 wt%, 40 wt% and 80 wt% and at a P:L ratio of 0.85 g/mL. The subsequently hardened structures were heat-treated, which initiated the melting of PEEK and dehydration of CSD (CaSO4.2H2O) to the CS anhydrite (CSA) (CaSO4) phase, which changed colour and apparent volume. FT-IR and SEM analysis revealed heat treatment of PEEK/CS specimens facilitated both physical and chemical interactions between phases. Over a period of 21 days of ageing in PBS, the hydration of CS was determined by XRD and improved specimen longevity at all levels of PEEK wt% loading was measured compared with the control. Importantly, increasing PEEK wt% loading resulted in a marked increase in the mechanical properties of PEEK/CS specimens in terms of both compressive strength and modulus. Conclusions Reinforcement of CS with PEEK significantly enhanced in vitro dissolution resistance, in addition to enhancing mechanical properties. This composite therefore has significant future potential as a bone graft replacement. Electronic supplementary material The online version of this article (doi:10.1186/s40824-017-0093-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Erik A B Hughes
- School of Chemical Engineering, University of Birmingham, Edgbaston, B15 2TT UK
| | - Liam M Grover
- School of Chemical Engineering, University of Birmingham, Edgbaston, B15 2TT UK
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Osteoinductive potential and bone-bonding ability of ProRoot MTA, MTA Plus and Biodentine in rabbit intramedullary model: Microchemical characterization and histological analysis. Dent Mater 2017; 33:e221-e238. [PMID: 28233601 DOI: 10.1016/j.dental.2017.01.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 01/10/2017] [Accepted: 01/31/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To study the in vivo osteoinductive potential, bone-bonding ability (bioactivity) and bone biomineralization of current hydraulic calcium silicate cements used as graft materials and placed in contact with medullary bone. METHODS ProRoot MTA, MTA Plus and Biodentine were used to fill surgical bone defects (2-mm diameter through the entire cortical thickness to reach the medullary bone) in the tibia of mature male rabbits. Tibiae were retrieved after 30days and submitted to histological analysis and microchemical characterization using Optical Microscopy (OM) and Environmental Scanning Electron Microscopy with Energy Dispersive X-ray analysis (ESEM-EDX). Bone neoformation and histomorphometric evaluations, degree of mineralization (by Ca/P, Ca/N and P/N ratios) and the diffusion of material elements were studied. RESULTS Bone neoformation was observed in response to all materials. No sign of necrosis were found on the walls of the pre-existing cortical bone. No osteoclasts and no formation of fibrous tissue were evident. Sign of angiogenesis were present. EDX (element content, line profile and element mapping) showed the increase in Ca and P and decrease in C, S and N from the mature bone towards the mineralizing interface. Ca/P, Ca/N and P/N ratios showed differences in the degree of mineralization/maturation stage of bone. MTA Plus and ProRoot MTA exhibited close contact with the pre-existing bone and good bone-bonding with neoformed bone juxtaposed on the medullary side of the materials without interposed connective tissue or resorption lacunae or gaps. The materials showed a dense appearance with 100% of residual materials and no colonization by fluids and cells. No migration of Bi or Al material elements to the newly formed bone was found. Biodentine showed newly formed trabecular bone with marrow spaces and sparse traces of residual material (≈9%). SIGNIFICANCE The in vivo osteoinductive properties with dynamic biomineralization processes around these calcium silicate materials extruded in medullary bone in appropriate animal model have been demonstrated by ESEM-EDX in association with OM. Good biocompatibility was evident as only slight inflammatory infiltrate and no sign of necrosis at the interface with the pre-existing bone were found. MTA Plus and ProRoot MTA exhibited bioactive potential as they can bond to bone directly without interposed connective tissue. Biodentine was replaced by newly formed bone. CLINICAL SIGNIFICANCE The results of the study demonstrate the capacity of calcium silicate cements to allow osteoid matrix deposition by activated osteoblasts and favour its biomineralization, and to achieve a direct bond between the (bioactive) materials surface and the mineralized bone matrix.
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Qi X, Pei P, Zhu M, Du X, Xin C, Zhao S, Li X, Zhu Y. Three dimensional printing of calcium sulfate and mesoporous bioactive glass scaffolds for improving bone regeneration in vitro and in vivo. Sci Rep 2017; 7:42556. [PMID: 28211911 PMCID: PMC5304193 DOI: 10.1038/srep42556] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 01/10/2017] [Indexed: 12/27/2022] Open
Abstract
In the clinic, bone defects resulting from infections, trauma, surgical resection and genetic malformations remain a significant challenge. In the field of bone tissue engineering, three-dimensional (3D) scaffolds are promising for the treatment of bone defects. In this study, calcium sulfate hydrate (CSH)/mesoporous bioactive glass (MBG) scaffolds were successfully fabricated using a 3D printing technique, which had a regular and uniform square macroporous structure, high porosity and excellent apatite mineralization ability. Human bone marrow-derived mesenchymal stem cells (hBMSCs) were cultured on scaffolds to evaluate hBMSC attachment, proliferation and osteogenesis-related gene expression. Critical-sized rat calvarial defects were applied to investigate the effect of CSH/MBG scaffolds on bone regeneration in vivo. The in vitro results showed that CSH/MBG scaffolds stimulated the adhesion, proliferation, alkaline phosphatase (ALP) activity and osteogenesis-related gene expression of hBMSCs. In vivo results showed that CSH/MBG scaffolds could significantly enhance new bone formation in calvarial defects compared to CSH scaffolds. Thus 3D printed CSH/MBG scaffolds would be promising candidates for promoting bone regeneration.
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Affiliation(s)
- Xin Qi
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Peng Pei
- School of Materials Science and Engineering, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai 200093, China
| | - Min Zhu
- School of Materials Science and Engineering, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai 200093, China
| | - Xiaoyu Du
- School of Materials Science and Engineering, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai 200093, China
| | - Chen Xin
- School of Materials Science and Engineering, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai 200093, China
| | - Shichang Zhao
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Xiaolin Li
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Yufang Zhu
- School of Materials Science and Engineering, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai 200093, China
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Antimicrobial Formulations of Absorbable Bone Substitute Materials as Drug Carriers Based on Calcium Sulfate. Antimicrob Agents Chemother 2016; 60:3897-905. [PMID: 27067337 DOI: 10.1128/aac.00080-16] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 04/01/2016] [Indexed: 11/20/2022] Open
Abstract
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.
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Cha JK, Lim HC, Lee JS, Choi SH, Woo KM, Jung UW. Sinus augmentation using a histone deacetylase inhibitor in a calcium sulfate carrier in rabbit: A pilot study. J Biomed Mater Res B Appl Biomater 2016; 105:1916-1923. [DOI: 10.1002/jbm.b.33727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 05/13/2016] [Accepted: 05/24/2016] [Indexed: 01/15/2023]
Affiliation(s)
- Jae Kook Cha
- Department of Periodontology; Research Institute for Periodontal Regeneration, Yonsei University, College of Dentistry; Seoul Republic of Korea
| | - Hyun-Chang Lim
- Department of Periodontology; School of Dentistry; Kyung Hee University; Seoul Republic of Korea
| | - Jung-Seok Lee
- Department of Periodontology; Research Institute for Periodontal Regeneration, Yonsei University, College of Dentistry; Seoul Republic of Korea
| | - Seong-Ho Choi
- Department of Periodontology; Research Institute for Periodontal Regeneration, Yonsei University, College of Dentistry; Seoul Republic of Korea
| | - Kyung Mi Woo
- Department of Pharmacology and Dental Therapeutics; School of Dentistry; Seoul National University; Seoul Republic of Korea
| | - Ui-Won Jung
- Department of Periodontology; Research Institute for Periodontal Regeneration, Yonsei University, College of Dentistry; Seoul Republic of Korea
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32
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Zizzari VL, Zara S, Tetè G, Vinci R, Gherlone E, Cataldi A. Biologic and clinical aspects of integration of different bone substitutes in oral surgery: a literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:392-402. [PMID: 27496576 DOI: 10.1016/j.oooo.2016.04.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 04/12/2016] [Indexed: 12/21/2022]
Abstract
Many bone substitutes have been proposed for bone regeneration, and researchers have focused on the interactions occurring between grafts and host tissue, as the biologic response of host tissue is related to the origin of the biomaterial. Bone substitutes used in oral and maxillofacial surgery could be categorized according to their biologic origin and source as autologous bone graft when obtained from the same individual receiving the graft; homologous bone graft, or allograft, when harvested from an individual other than the one receiving the graft; animal-derived heterologous bone graft, or xenograft, when derived from a species other than human; and alloplastic graft, made of bone substitute of synthetic origin. The aim of this review is to describe the most commonly used bone substitutes, according to their origin, and to focus on the biologic events that ultimately lead to the integration of a biomaterial with the host tissue.
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Affiliation(s)
| | - Susi Zara
- Department of Pharmacy, University "G. d'Annunzio", Chieti, Italy
| | - Giulia Tetè
- Dental School, Vita-Salute University and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy
| | - Raffaele Vinci
- Dental School, Vita-Salute University and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy
| | - Enrico Gherlone
- Dental School, Vita-Salute University and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy
| | - Amelia Cataldi
- Department of Pharmacy, University "G. d'Annunzio", Chieti, Italy
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Chen Y, Zhou Y, Yang S, Li JJ, Li X, Ma Y, Hou Y, Jiang N, Xu C, Zhang S, Zeng R, Tu M, Yu B. Novel bone substitute composed of chitosan and strontium-doped α-calcium sulfate hemihydrate: Fabrication, characterisation and evaluation of biocompatibility. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 66:84-91. [PMID: 27207041 DOI: 10.1016/j.msec.2016.04.070] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 04/11/2016] [Accepted: 04/18/2016] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Yirong Chen
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, People's Republic of China
| | - Yilin Zhou
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, People's Republic of China
| | - Shenyu Yang
- Department of Materials Science and Engineering, College of Science and Engineering, Jinan University, Guangzhou 510632, People's Republic of China
| | - Jiao Jiao Li
- Biomaterials and Tissue Engineering Research Unit, School of AMME, University of Sydney, Sydney, NSW 2006, Australia
| | - Xue Li
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, People's Republic of China
| | - Yunfei Ma
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, People's Republic of China
| | - Yilong Hou
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, People's Republic of China
| | - Nan Jiang
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, People's Republic of China
| | - Changpeng Xu
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, People's Republic of China
| | - Sheng Zhang
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, People's Republic of China
| | - Rong Zeng
- Department of Materials Science and Engineering, College of Science and Engineering, Jinan University, Guangzhou 510632, People's Republic of China
| | - Mei Tu
- Department of Materials Science and Engineering, College of Science and Engineering, Jinan University, Guangzhou 510632, People's Republic of China.
| | - Bin Yu
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, People's Republic of China.
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Enhanced Stability of Calcium Sulfate Scaffolds with 45S5 Bioglass for Bone Repair. MATERIALS 2015; 8:7498-7510. [PMID: 28793652 PMCID: PMC5458930 DOI: 10.3390/ma8115398] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/29/2015] [Accepted: 11/02/2015] [Indexed: 11/17/2022]
Abstract
Calcium sulfate (CaSO4), as a promising tissue repair material, has been applied widely due to its outstanding bioabsorbability and osteoconduction. However, fast disintegration, insufficient mechanical strength and poor bioactivity have limited its further application. In the study, CaSO4 scaffolds fabricated by using selective laser sintering were improved by adding 45S5 bioglass. The 45S5 bioglass enhanced stability significantly due to the bond effect of glassy phase between the CaSO4 grains. After immersing for four days in simulated body fluid (SBF), the specimens with 45S5 bioglass could still retain its original shape compared as opposed to specimens without 45S5 bioglass who experienced disintegration. Meanwhile, its compressive strength and fracture toughness increased by 80% and 37%, respectively. Furthermore, the apatite layer was formed on the CaSO4 scaffolds with 45S5 bioglass in SBF, indicating good bioactivity of the scaffolds. In addition, the scaffolds showed good ability to support the osteoblast-like cell adhesion and proliferation.
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A Novel Injectable Magnesium/Calcium Sulfate Hemihydrate Composite Cement for Bone Regeneration. BIOMED RESEARCH INTERNATIONAL 2015; 2015:297437. [PMID: 26114102 PMCID: PMC4465663 DOI: 10.1155/2015/297437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 03/18/2015] [Indexed: 11/23/2022]
Abstract
Objective. A novel injectable magnesium/calcium sulfate hemihydrate (Mg/CSH) composite with improved properties was reported here. Methods. Composition, setting time, injectability, compressive strength, and bioactivity in simulated body fluid (SBF) of the Mg/CSH composite were evaluated. Furthermore, the cellular responses of canine bone marrow stromal cells (cBMSCs) and bone formation capacity after the implantation of Mg/CSH in tibia defects of canine were investigated. Results. Mg/CSH possessed a prolonged setting time and markedly improved injectability and mechanical property (p < 0.05). Mg/CSH samples showed better degradability than CSH in SBF after 21 days of soaking (p < 0.05). Moreover, the degrees of cell attachment, proliferation, and capability of osteogenic differentiation on the Mg/CSH specimens were higher than those on CSH, without significant cytotoxicity and with the increased proliferation index, ALP activity, and expression levels of integrin β1 and Coll I in cBMSCs (p < 0.05). Mg/CSH enhanced the efficiency of new bone formation at the tibia defect area, including the significantly elevated bone mineral density, bone area fraction, and Coll I expression level (p < 0.05). Conclusions. The results implied that this new injectable bone scaffold exhibited promising prospects for bone repair and had a great potential in bone tissue engineering.
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Dewi AH, Ana ID, Wolke J, Jansen J. Behavior of POP-calcium carbonate hydrogel as bone substitute with controlled release capability: A study in rat. J Biomed Mater Res A 2015; 103:3273-83. [DOI: 10.1002/jbm.a.35460] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/17/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Anne Handrini Dewi
- Department of Dental Biomedical Sciences; Faculty of Dentistry; GadjahMada University; Yogyakarta 55281 Indonesia
| | - Ika Dewi Ana
- Department of Dental Biomedical Sciences; Faculty of Dentistry; GadjahMada University; Yogyakarta 55281 Indonesia
| | - Joop Wolke
- Department of Biomaterials; Radboud University Medical Center; Nijmegen 6500 HB The Netherlands
| | - John Jansen
- Department of Biomaterials; Radboud University Medical Center; Nijmegen 6500 HB The Netherlands
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Li H, Gu J, Shah LA, Siddiq M, Hu J, Cai X, Yang D. Bone cement based on vancomycin loaded mesoporous silica nanoparticle and calcium sulfate composites. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 49:210-216. [DOI: 10.1016/j.msec.2014.12.082] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 11/13/2014] [Accepted: 12/24/2014] [Indexed: 12/20/2022]
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Shen Y, Yang S, Liu J, Xu H, Shi Z, Lin Z, Ying X, Guo P, Lin T, Yan S, Huang Q, Peng L. Engineering scaffolds integrated with calcium sulfate and oyster shell for enhanced bone tissue regeneration. ACS APPLIED MATERIALS & INTERFACES 2014; 6:12177-12188. [PMID: 25033438 DOI: 10.1021/am501448t] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Engineering scaffolds combinging natural biomineral and artificially synthesized material hold promising potential for bone tissue regeneration. In this study, novel bioactive calcium sulfate/oyster shell (CS/OS) composites were prepared. Comparing to CS scaffold, the CS/OS composites with a controllable degradation rate displayed enhanced mineral nodule formation, higher alkaline phosphate (ALP) activity and increased proliferation rate while treated osteocytes. In CS/OS composites group, elevated mRNA levels of key osteogenic genes including bone morphogenetic protein-2 (BMP-2), runt-related transcription factor 2 (Runx2), osterix (Osx), and osteocalcin (OCN) were observed. Furthermore, The up-regulation of BMP-2 and type I collagen (COL-I) was observed for CS/OS composites relative to a CS group. Scaffolds were implanted into critical-sized femur cavity defects in rabbits to investigate the osteogenic capacity of the composites in vivo. The CS/OS scaffolds with proper suitable times and mechanical strength strongly promoted osteogenic tissue regeneration relative to the regeneration capacity of CS scaffolds, as indicated by the results of histological staining. These results suggest that the OS-modified CS engineering scaffolds with improved mechanical properties and bioactivity would facilitate the development of a new strategy for clinic bone defect regeneration.
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Affiliation(s)
- Yue Shen
- Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou 310009, Zhejiang China
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Turri A, Dahlin C. Comparative maxillary bone-defect healing by calcium-sulphate or deproteinized bovine bone particles and extra cellular matrix membranes in a guided bone regeneration setting: an experimental study in rabbits. Clin Oral Implants Res 2014; 26:501-6. [PMID: 24954120 DOI: 10.1111/clr.12425] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this study was to histologically compare the dynamics of bone healing response between calcium sulphate (CaS) and deproteinized bovine bone mineral (DBBM) particles in guided bone regeneration utilizing an extracellular matrix membrane (ECM) as barrier. MATERIALS AND METHODS Eighteen rabbits were used in thisstudy. 5 × 5 mm defects were created in the edentulous space between the incisors and molars in the maxilla. The CaS and DBBM particles were placed in the defects, with or without the placement of a membrane by means of random selection. Healing was evaluated at 2, 4 and 8 weeks by histology. RESULTS A total resorption of the CaS material was seen already at 2 weeks. Only minor resorption could be seen of the DBBM particles. The CaS group showed significantly more bone regeneration at all three healing periods compared to the DBBM group. The addition of an ECM membrane demonstrated significant additional effect on bone regeneration. The CaS group showed significant increased amounts of blood vessels compared to the DBBM group. CONCLUSIONS Thisstudy showed that CaS in combination with an ECM membrane provided synergistic effects on bone regeneration, seemingly due to stimulating angiogenesis in the early healing process.
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Affiliation(s)
- Alberto Turri
- Department of Biomaterials, BIOMATCELL VINN Excellence Center, Institute for Surgical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Brånemark Clinic, Institute of Odontology, Public Dental Health Care, Gothenburg, Sweden
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Xu G, Fu X, Du C, Ma J, Li Z, Ma X. Biomechanical effects of vertebroplasty on thoracolumbar burst fracture with transpedicular fixation: a finite element model analysis. Orthop Traumatol Surg Res 2014; 100:379-83. [PMID: 24835003 DOI: 10.1016/j.otsr.2014.03.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 12/17/2013] [Accepted: 03/13/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the biomechanical effects of augmentation of the fractured vertebrae after posterior instrumentation. METHODS By simulating internal fixation plus augmentation with cement, eight tridimensional, anatomically detailed finite element models of the T11-L1 functional spinal junction were developed. Two kinds of models for mimicking different severity of the fracture were established according to the Denis' classification. Augmentation with cement was conducted after reduction with posterior fixation using a universal spine system. These models assumed a three-column loading configuration as follows: compression, anteflexion, extension, lateroflexion and axial rotation. Stress of the implants and spine was evaluated. RESULTS Data showed that for severely fractured models, augmentation apparently decreased the von Mises stresses by 50% for the rods and 40% for the screws, about 40% for the inferior endplate of T11, and 50% for the superior endplate of L1 in vertical compression and other load situations. CONCLUSION We should only apply vertebroplasty to prevent correction loss and implants failure based on the fact that it could significantly decrease stress of the instrumentations and spine when the vertebrae are severely fractured. LEVEL OF EVIDENCE Level IV, biomechanical study.
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Affiliation(s)
- G Xu
- Biomechanics Labs of Orthopaedic Institute, Tianjin Hospital, 406, Jiefang Nan Street, Hexi District, 300211 Tianjin, China
| | - X Fu
- Biomechanics Labs of Orthopaedic Institute, Tianjin Hospital, 406, Jiefang Nan Street, Hexi District, 300211 Tianjin, China
| | - C Du
- Department of Orthopaedics, Binzhou Medical University Hospital, 661 Yellow River Road, 256603 Binzhou, China
| | - J Ma
- Biomechanics Labs of Orthopaedic Institute, Tianjin Hospital, 406, Jiefang Nan Street, Hexi District, 300211 Tianjin, China
| | - Z Li
- Department of Orthopaedics, Tianjin Medical University General Hospital, 154 Anshan Street, Heping District, 300052 Tianjin, China; Department of Immunology, Tianjin Medical University, 22 Qixiangtai Road, Heping District, 300070 Tianjin, China
| | - X Ma
- Biomechanics Labs of Orthopaedic Institute, Tianjin Hospital, 406, Jiefang Nan Street, Hexi District, 300211 Tianjin, China.
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Jang Y, Kim H, Roh BD, Kim E. Biologic response of local hemostatic agents used in endodontic microsurgery. Restor Dent Endod 2014; 39:79-88. [PMID: 24790919 PMCID: PMC3978108 DOI: 10.5395/rde.2014.39.2.79] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 02/24/2014] [Indexed: 11/11/2022] Open
Abstract
Appropriate use of local hemostatic agent is one of the important factors on the prognosis of endodontic microsurgery. However, most investigations to date focus on the hemostatic efficacy of the agents, whereas their biologic characteristics have not received enough attention. The purpose of this paper was to review the biologic response of local hemostatic agents, and to provide clinical guidelines on their use during endodontic microsurgery. Electronic database (PUBMED) was screened to search related studies from 1980 to 2013, and 8 clinical studies and 18 animal studies were identified. Among the materials used in these studies, most widely-investigated and used materials, epinephrine, ferric sulfate (FS) and calcium sulfate (CS), were thoroughly discussed. Influence of these materials on local tissue and systemic condition, such as inflammatory and foreign body reaction, local ischemia, dyspigmentation, delayed or enhanced bone and soft tissue healing, and potential cardiovascular complications were assessed. Additionally, biological property of their carrier materials, cotton pellet and absorbable collagen, were also discussed. Clinicians should be aware of the biologic properties of local hemostatic agents and their carrier materials, and should pay attention to the potential complications when using them in endodontic microsurgery.
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Affiliation(s)
- Youngjune Jang
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyeon Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Byoung-Duck Roh
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Euiseong Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
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Yang G, Liu J, Li F, Pan Z, Ni X, Shen Y, Xu H, Huang Q. Bioactive calcium sulfate/magnesium phosphate cement for bone substitute applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2013; 35:70-6. [PMID: 24411353 DOI: 10.1016/j.msec.2013.10.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Revised: 09/29/2013] [Accepted: 10/19/2013] [Indexed: 10/26/2022]
Abstract
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.
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Affiliation(s)
- Guangyong Yang
- Department of Orthopaedics, Taizhou Hospital of Zhejiang Province, Linhai Zhejiang, 317000, China; Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, 325000, China
| | - Jianli Liu
- Trauma Center, Affiliated Hospital of Hainan Medical University, Haikou, Hainan, 570206, China; Division of Functional Materials and Nanodevices, Ningbo Institute of Materials Technology and Engineering (NIMTE), Chinese Academy of Sciences (CAS), Ningbo, Zhejiang, 315201, China
| | - Fan Li
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, 325000, China
| | - Zongyou Pan
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, 325000, China
| | - Xiao Ni
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, 325000, China
| | - Yue Shen
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, 325000, China
| | - Huazi Xu
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, 325000, China.
| | - Qing Huang
- Division of Functional Materials and Nanodevices, Ningbo Institute of Materials Technology and Engineering (NIMTE), Chinese Academy of Sciences (CAS), Ningbo, Zhejiang, 315201, China.
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Liu W, Wu C, Liu W, Zhai W, Chang J. The effect of plaster (CaSO4·1/2H2O) on the compressive strength, self-setting property, and in vitro bioactivity of silicate-based bone cement. J Biomed Mater Res B Appl Biomater 2012; 101:279-86. [DOI: 10.1002/jbm.b.32837] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 09/13/2012] [Accepted: 09/25/2012] [Indexed: 11/09/2022]
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Wessely-Szponder J, Bobowiec R, Szponder T. The influence of porcine prophenin on neutrophils isolated from rabbit blood during implantation of calcium sulphate graft material into bone tissue. WORLD RABBIT SCIENCE 2012. [DOI: 10.4995/wrs.2012.1149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Kuo ST, Wu HW, Tuan WH, Tsai YY, Wang SF, Sakka Y. Porous calcium sulfate ceramics with tunable degradation rate. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2012; 23:2437-2443. [PMID: 22752883 DOI: 10.1007/s10856-012-4704-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Accepted: 06/11/2012] [Indexed: 06/01/2023]
Abstract
It would be ideal if bone substitutes could be absorbed by the human body upon the formation of new bone. Although calcium sulfate is absorbable, its biodegradation rate is very fast. Fortunately, this rate can be reduced significantly through various sintering techniques. This study demonstrates that the degradation rate of sintered CS specimens can be adjusted through the introduction of pores. Through various techniques, we introduced spherical pores with amounts ranging from 6.7 to 68 % into sintered CS specimens. The corresponding degradation rate in Hank's solution varied from 1.9 to 7.7 %/day and the cytotoxicity test results indicated low toxicity within the sintered CS specimens.
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Affiliation(s)
- Shu-Ting Kuo
- Department of Materials Science and Engineering, National Taiwan University, Taipei 10617, Taiwan
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Pettinicchio M, Sammons R, Caputi S, Piattelli A, Traini T. Bone regeneration in sinus augmentation procedures with calcium sulphate. Microstructure and microanaytical investigations. Aust Dent J 2012; 57:200-6. [DOI: 10.1111/j.1834-7819.2012.01684.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Liu X, Liu HY, Lian X, Shi XL, Wang W, Cui FZ, Zhang Y. Osteogenesis of mineralized collagen bone graft modified by PLA and calcium sulfate hemihydrate: in vivo study. J Biomater Appl 2012; 28:12-9. [PMID: 22274876 DOI: 10.1177/0885328211433618] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this study, the biocompatibility and bone regeneration performance of nano-hydroxyapatite/collagen/poly(L-lactide) (nHAC/PLA) and nano-hydroxyapatite/collagen/calcium sulfate hemihydrate (nHAC/CSH) as bone-filling materials were evaluated and compared in a critical box-shaped defect model in the mandible of the rabbits. In vivo results indicated that there was significant difference in early bone remodeling between two types of bone substitutes. nHAC/PLA has shown excellent biocompatibility, but no adequate handling properties. The addition of CSH to nHAC provided better manipulability compared to nHAC/PLA. Furthermore, nHAC/CSH possesses superior properties in restoring critical-sized bone defects of maxillofacial region at the early stage of remodeling over nHAC/PLA. Our results suggested that nHAC/CSH could be an alternative to the conventionally used bone tissue engineering materials.
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Affiliation(s)
- Xi Liu
- State Key Laboratory of New Ceramic and Fine Processing, Department of Materials Science and Engineering, Tsinghua University, Beijing, China
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Anand A, Pundir R, Pandian CS, Saraf S, Gupta H. Cefoperazone sodium impregnated polycaprolactone composite implant for osteomyelitis. Indian J Pharm Sci 2011; 71:377-81. [PMID: 20502542 PMCID: PMC2865808 DOI: 10.4103/0250-474x.57285] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Revised: 07/03/2009] [Accepted: 07/04/2009] [Indexed: 11/05/2022] Open
Abstract
The use of local antibiotics from a biodegradable implant for chronic osteomyelitis is an attractive alternative. The implant delivers high antibiotic concentration at tissue levels, obliterates dead space, aids bone repair and does not need to be removed. The purpose of this paper is to develop and evaluate a calcium sulphate and polycaprolactone based composite biodegradable implantable delivery system of cefoperazone sodium. Implants were prepared by modified fabrication technique to avoid solvent use. Interaction studies were carried out to check any incompatibility between ingredients. Prepared implants were evaluated for various in vitro parameters like dimensions, hardness, tensile strength, drug release profile and sterility. Morphological changes in pellet before and after drug release were evaluated by scanning electron microscopy. The pellet were also tested for microbiological efficacy and compared with plain drug solution in different concentrations. Developed pellets are regular in shape and size with good tensile strength. The release profile displayed drug levels above MIC continuously up to 2 months. Wide zone of inhibition by pellet against Staph. aureus as compared to drug solution proves its efficacy in treatment of osteomyelitis.
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Affiliation(s)
- A Anand
- Babu Banarasi Das National Institute of Technology & Management, Lucknow-226 007, India
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Assessing the character of the rhBMP-2- and vancomycin-loaded calcium sulphate composites in vitro and in vivo. Arch Orthop Trauma Surg 2011; 131:991-1001. [PMID: 21318424 DOI: 10.1007/s00402-011-1269-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2010] [Indexed: 02/09/2023]
Abstract
BACKGROUND The treatment of contaminated and infected bone defects remains an intractable problem and the ideal approach is to control infection and repair the bone defect at the same time. Thus, developing an osteoconductive bone graft composite with antibiotic and growth factor release capabilities as well as osteogenesis-matched degradation properties is necessary. A new calcium sulphate composite consisting of vancomycin and rhBMP-2 was developed, and the present study assessed its efficiency in vitro and in a rabbit tibial defect model. METHODS Firstly, we detected the bioactivity of rhBMP-2 released from the composites by ALP assay in vitro. Then, the released vancomycin in bone tissue within 1 cm from implanted site was detected by HLPC at 1, 3, 5, 7, 14, 21 and 28 days after implantation. The rhBMP-2 concentration of tissues around the defects was also detected by ELISA. Histomorphometry and histomorphometrical analysis at 5, 14 and 28 days post-implantation was done for assessing its osteoinductivity for bone defects. RESULTS The results showed rhBMP-2 was still active in vitro at 29 days. In vivo, the composite released an initial bolus of vancomycin and rhBMP-2 to the bone followed by gradual release for more than 14 and 21 days, respectively. The histomorphometry indicated that the composite significantly augmented new bone formation in the defect compared to the control. CONCLUSIONS This composite may be a potential therapeutic agent for contaminated or infected bone defects due to its concomitant osteoinductive and antibiotic properties.
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Cortez PP, Silva MA, Santos M, Armada-da-Silva P, Afonso A, Lopes MA, Santos JD, Maurício AC. A glass-reinforced hydroxyapatite and surgical-grade calcium sulfate for bone regeneration: In vivo biological behavior in a sheep model. J Biomater Appl 2011; 27:201-17. [PMID: 21602251 DOI: 10.1177/0885328211399479] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A glass-reinforced hydroxyapatite (HA) composite (Bonelike®) was developed for bone grafting. This biomaterial is composed of a modified HA matrix with α- and β-tricalcium phosphate secondary phases, resulting in higher solubility than single HA type of materials. Several in vitro and in vivo studies demonstrated that Bonelike® has a highly bioactive behavior, which was also confirmed by employing granular forms of this biomaterial in orthopedics and dental applications. However, a fast consolidation vehicle was needed to promote the fixation of Bonelike® granules if applied in larger defects or in unstable sites. Surgical-grade calcium sulfate (CS), which is widely recognized as a well-tolerated and inexpensive bone graft material, was the chosen vehicle to improve the handling characteristics of Bonelike® as it can be used in the form of a powder that is mixed with a liquid to form a paste that sets in situ. After application in non-critical monocortical defects in sheep, histological, and scanning electron microscopy evaluations demonstrated that Bonelike® associated to CS functioned as a very satisfactory scaffold for bone regeneration as it achieved synchronization of the ingrowing bone with biomaterial resorption and subsequent preservation of the bone graft initial volume. Therefore, our results indicate that CS is an effective vehicle for Bonelike® granules as it facilitates their application and does not interfere with their proven highly osteoconductive properties. In the opposite way, the incorporation of Bonelike® improves the bone regeneration capabilities of CS.
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Affiliation(s)
- Paulo Pegado Cortez
- Centro de Estudos de Ciência Animal-CECA, Instituto de Ciências e Tecnologias Agrárias e Agro-Alimentares-ICETA, Universidade do Porto, Campus Agrário de Vairão, 4485-661 Vairão, Portugal.
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