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Escalante LMT, Tsuchiya A, Zhanrui L, Morinobu M, Ishikawa K. Fabrication and histological evaluation of a self-setting granular cement using calcium sulfate hemihydrate granules with different pore distribution. Dent Mater J 2024; 43:573-581. [PMID: 38853007 DOI: 10.4012/dmj.2023-248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Granular type of bone substitutes is currently used in the field of dentistry to restore alveolar bone defects. However, the migration of the granules from the implantation site is still an unresolved issue. In this study, the feasibility to fabricate self-setting calcium sulfate hemihydrate (CSH) granules using different ranges of loading pressure: CSH(0), CSH(50), CSH(100), and CSH(150) was investigated with the hypothesis that CSH granules with reduced microporosity can inhibit the rapid dissolution rate of the calcium sulfate dihydrate (CSD) set blocks and induce bone regeneration. After 4 weeks of implantation, the granules were mostly replaced with new bone although no significant differences were observed. Nevertheless, the granules demonstrated the ability to set within the bone defect. It is therefore concluded that the setting ability of calcium sulfate can contribute to address the issue of migration of the granules and provide a useful guide for designing setting bone substitutes.
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Affiliation(s)
| | - Akira Tsuchiya
- Department of Biomaterials, Faculty of Dental Science, Kyushu University
| | - Lou Zhanrui
- Department of Biomaterials, Faculty of Dental Science, Kyushu University
| | - Miki Morinobu
- Department of Biomaterials, Faculty of Dental Science, Kyushu University
| | - Kunio Ishikawa
- Department of Biomaterials, Faculty of Dental Science, Kyushu University
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Peng S, Yang X, Zou W, Chen X, Deng H, Zhang Q, Yan Y. A Bioactive Degradable Composite Bone Cement Based on Calcium Sulfate and Magnesium Polyphosphate. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1861. [PMID: 38673218 PMCID: PMC11051185 DOI: 10.3390/ma17081861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/06/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
Calcium sulfate bone cement (CSC) is extensively used as a bone repair material due to its ability to self-solidify, degradability, and osteogenic ability. However, the fast degradation, low mechanical strength, and insufficient biological activity limit its application. This study used magnesium polyphosphate (MPP) and constructed a composite bone cement composed of calcium sulfate (CS), MPP, tricalcium silicate (C3S), and plasticizer hydroxypropyl methylcellulose (HPMC). The optimized CS/MPP/C3S composite bone cement has a suitable setting time of approximately 15.0 min, a compressive strength of 26.6 MPa, and an injectability of about 93%. The CS/MPP/C3S composite bone cement has excellent biocompatibility and osteogenic capabilities; our results showed that cell proliferation is up to 114% compared with the control after 5 days. After 14 days, the expression levels of osteogenic-related genes, including Runx2, BMP2, OCN, OPN, and COL-1, are about 1.8, 2.8, 2.5, 2.2, and 2.2 times higher than those of the control, respectively, while the alkaline phosphatase activity is about 1.7 times higher. Therefore, the CS/MPP/C3S composite bone cement overcomes the limitations of CSC and has more effective potential in bone repair.
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Affiliation(s)
- Suping Peng
- School of Chemical Engineering, Sichuan University, Chengdu 610065, China
| | - Xinyue Yang
- School of Chemical Engineering, Sichuan University, Chengdu 610065, China
| | - Wangcai Zou
- School of Chemical Engineering, Sichuan University, Chengdu 610065, China
| | - Xiaolu Chen
- College of Physics, Sichuan University, Chengdu 610065, China
| | - Hao Deng
- College of Physics, Sichuan University, Chengdu 610065, China
| | - Qiyi Zhang
- School of Chemical Engineering, Sichuan University, Chengdu 610065, China
| | - Yonggang Yan
- College of Physics, Sichuan University, Chengdu 610065, China
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Eikani C, Hoyt A, Cho E, Levack AE. The State of Local Antibiotic Use in Orthopedic Trauma. Orthop Clin North Am 2024; 55:207-216. [PMID: 38403367 DOI: 10.1016/j.ocl.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Fracture-related infections are a challenging complication in orthopedic trauma that often necessitates multiple surgeries. Early administration of systemic antibiotics and surgical intervention remains the gold standard of care, but despite these measures, treatment failures can be as high as 35%. For these reasons, the introduction of local antibiotics at the site of at-risk fractures has increased over the past decade. This review looks at the various measures being used clinically including local antibiotic powder, polymethylmethacrylate, biodegradable substances, antibiotic-coated implants, and novel methods such as hydrogels and nanoparticles that have the potential for use in the future.
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Affiliation(s)
- Carlo Eikani
- Loyola University Stritch School of Medicine; Department of Orthopaedic Surgery & Rehabilitation, Loyola University Medical Center, 2160 South 1st Avenue, Maguire Suite 1700, Maywood, IL, USA.
| | - Aaron Hoyt
- Department of Orthopaedic Surgery & Rehabilitation, Loyola University Medical Center, 2160 South 1st Avenue, Maguire Suite 1700, Maywood, IL, USA
| | - Elizabeth Cho
- Department of Orthopaedic Surgery & Rehabilitation, Loyola University Medical Center, 2160 South 1st Avenue, Maguire Suite 1700, Maywood, IL, USA
| | - Ashley E Levack
- Loyola University Stritch School of Medicine; Department of Orthopaedic Surgery & Rehabilitation, Loyola University Medical Center, 2160 South 1st Avenue, Maguire Suite 1700, Maywood, IL, USA
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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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Nicoara AI, Voineagu TG, Alecu AE, Vasile BS, Maior I, Cojocaru A, Trusca R, Popescu RC. Fabrication and Characterisation of Calcium Sulphate Hemihydrate Enhanced with Zn- or B-Doped Hydroxyapatite Nanoparticles for Hard Tissue Restoration. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:2219. [PMID: 37570539 PMCID: PMC10421315 DOI: 10.3390/nano13152219] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023]
Abstract
A composite based on calcium sulphate hemihydrate enhanced with Zn- or B-doped hydroxyapatite nanoparticles was fabricated and evaluated for bone graft applications. The investigations of their structural and morphological properties were performed by X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), and energy dispersive X-ray (EDX) spectroscopy techniques. To study the bioactive properties of the obtained composites, soaking tests in simulated body fluid (SBF) were performed. The results showed that the addition of 2% Zn results in an increase of 2.27% in crystallinity, while the addition of boron causes an increase of 5.61% compared to the undoped HAp sample. The crystallite size was found to be 10.69 ± 1.59 nm for HAp@B, and in the case of HAp@Zn, the size reaches 16.63 ± 1.83 nm, compared to HAp, whose crystallite size value was 19.44 ± 3.13 nm. The mechanical resistance of the samples doped with zinc was the highest and decreased by about 6% after immersion in SBF. Mixing HAp nanoparticles with gypsum improved cell viability compared to HAp for all concentrations (except for 200 µg/mL). Cell density decreased with increasing nanoparticle concentration, compared to gypsum, where the cell density was not significantly affected. The degree of cellular differentiation of osteoblast-type cells was more accentuated in the case of samples treated with G+HAp@B nanoparticles compared to HAp@B. Cell viability in these samples decreased inversely proportionally to the concentration of administered nanoparticles. From the point of view of cell density, this confirmed the quantitative data.
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Affiliation(s)
- Adrian Ionut Nicoara
- Faculty of Chemical Engineering and Biotechnologies, University Politehnica of Bucharest, 060042 Bucharest, Romania; (A.I.N.); (A.E.A.); (I.M.); (R.T.)
- National Research Center for Micro and Nanomaterials, University Politehnica of Bucharest, 060042 Bucharest, Romania;
- National R&D Institute for Nonferrous and Rare Metals–IMNR, 077145 Bucharest, Romania
| | - Teodor Gabriel Voineagu
- Faculty of Medical Engineering, University Politehnica of Bucharest, 060042 Bucharest, Romania; (T.G.V.); (R.C.P.)
| | - Andrada Elena Alecu
- Faculty of Chemical Engineering and Biotechnologies, University Politehnica of Bucharest, 060042 Bucharest, Romania; (A.I.N.); (A.E.A.); (I.M.); (R.T.)
| | - Bogdan Stefan Vasile
- National Research Center for Micro and Nanomaterials, University Politehnica of Bucharest, 060042 Bucharest, Romania;
- Research Center for Advanced Materials, Products and Processes, University Politehnica of Bucharest, 060042 Bucharest, Romania
| | - Ioana Maior
- Faculty of Chemical Engineering and Biotechnologies, University Politehnica of Bucharest, 060042 Bucharest, Romania; (A.I.N.); (A.E.A.); (I.M.); (R.T.)
| | - Anca Cojocaru
- Faculty of Chemical Engineering and Biotechnologies, University Politehnica of Bucharest, 060042 Bucharest, Romania; (A.I.N.); (A.E.A.); (I.M.); (R.T.)
| | - Roxana Trusca
- Faculty of Chemical Engineering and Biotechnologies, University Politehnica of Bucharest, 060042 Bucharest, Romania; (A.I.N.); (A.E.A.); (I.M.); (R.T.)
- National Research Center for Micro and Nanomaterials, University Politehnica of Bucharest, 060042 Bucharest, Romania;
| | - Roxana Cristina Popescu
- Faculty of Medical Engineering, University Politehnica of Bucharest, 060042 Bucharest, Romania; (T.G.V.); (R.C.P.)
- National R&D Institute for Physics and Nuclear Engineering-Horia Hulubei, 077125 Magurele, Romania
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Liu J, Wang Y, Liang Y, Zhu S, Jiang H, Wu S, Ge X, Li Z. Effect of Platelet-Rich Plasma Addition on the Chemical Properties and Biological Activity of Calcium Sulfate Hemihydrate Bone Cement. Biomimetics (Basel) 2023; 8:262. [PMID: 37366857 DOI: 10.3390/biomimetics8020262] [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: 04/27/2023] [Revised: 06/04/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023] Open
Abstract
Currently, platelet-rich plasma (PRP) is an attractive additive for bone repair materials. PRP could enhance the osteoconductive and osteoinductive of bone cement, as well as modulate the degradation rate of calcium sulfate hemihydrate (CSH). The focus of this study was to investigate the effect of different PRP ratios (P1: 20 vol%, P2: 40 vol%, and P3: 60 vol%) on the chemical properties and biological activity of bone cement. The injectability and compressive strength of the experimental group were significantly higher than those of the control. On the other hand, the addition of PRP decreased the crystal size of CSH and prolonged the degradation time. More importantly, the cell proliferation of L929 and MC3T3-E1 cells was promoted. Furthermore, qRT-PCR, alizarin red staining, and western blot analyses showed that the expressions of osteocalcin (OCN) and Runt-related transcription factor 2 (Runx2) genes and β-catenin protein were up-regulated, and mineralization of extracellular matrix was enhanced. Overall, this study provided insight into how to improve the biological activity of bone cement through PRP incorporation.
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Affiliation(s)
- Jingyu Liu
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Yaguan Road 135#, Tianjin 300072, China
| | - Yifan Wang
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Yaguan Road 135#, Tianjin 300072, China
| | - Yanqin Liang
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Yaguan Road 135#, Tianjin 300072, China
| | - Shengli Zhu
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Yaguan Road 135#, Tianjin 300072, China
| | - Hui Jiang
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Yaguan Road 135#, Tianjin 300072, China
| | - Shuilin Wu
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Yaguan Road 135#, Tianjin 300072, China
| | - Xiang Ge
- Key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, Tianjin 300354, China
| | - Zhaoyang Li
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Yaguan Road 135#, Tianjin 300072, China
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Development of Injectable Calcium Sulfate and Self-Setting Calcium Phosphate Composite Bone Graft Materials for Minimally Invasive Surgery. Int J Mol Sci 2022; 23:ijms23147590. [PMID: 35886941 PMCID: PMC9323769 DOI: 10.3390/ijms23147590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/02/2022] [Accepted: 07/06/2022] [Indexed: 11/16/2022] Open
Abstract
The demand of bone grafting is increasing as the population ages worldwide. Although bone graft materials have been extensively developed over the decades, only a few injectable bone grafts are clinically available and none of them can be extruded from 18G needles. To overcome the existing treatment limitations, the aim of this study is to develop ideal injectable implants from biomaterials for minimally invasive surgery. An injectable composite bone graft containing calcium sulfate hemihydrate, tetracalcium phosphate, and anhydrous calcium hydrogen phosphate (CSH/CaP paste) was prepared with different CSH/CaP ratios and different concentrations of additives. The setting time, injectability, mechanical properties, and biocompatibility were evaluated. The developed injectable CSH/CaP paste (CSH/CaP 1:1 supplemented with 6% citric acid and 2% HPMC) presented good handling properties, great biocompatibility, and adequate mechanical strength. Furthermore, the paste was demonstrated to be extruded from a syringe equipped with 18G needles and exerted a great potential for minimally invasive surgery. The developed injectable implants with tissue repairing potentials will provide an ideal therapeutic strategy for minimally invasive surgery to apply in the treatment of maxillofacial defects, certain indications in the spine, inferior turbinate for empty nose syndrome (ENS), or reconstructive rhinoplasty.
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Putranto AW, Suprastiwi E, Meidyawati R, Agusnar H. Characterization of Novel Cement-Based Carboxymethyl Chitosan/Amorphous Calcium Phosphate. Eur J Dent 2022; 16:809-814. [PMID: 35016237 DOI: 10.1055/s-0041-1739449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE This study aimed to analyze, evaluate, and characterize novel cement-based carboxymethyl chitosan/amorphous calcium phosphate (CMC/ACP). MATERIALS AND METHODS The three cement groups studied were gypsum (Gyp), and CMC/ACP-gypsum cement-based 5% (5% CAG) and 10% (10% CAG). The groups were characterized using Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), setting time, and scanning electron microscopy (SEM) data. The characterization results were analyzed qualitatively, but the data for setting time were analyzed using SPSS (p < 0.05). STATISTICAL ANALYSIS Data were statistically analyzed. One-way analysis of variance was used to compare numerical (parametric) data between more than two separate groups followed by post hoc Tukey. RESULTS FTIR showed phosphate groups indicate the presence of calcium phosphate in the form of amorphous (ACP) in the CMC/ACP, CMC/ACP post-milled powder, and CMC/ACP cement-based (5% CAG and 10% CAG). XRD showed no difference in the diffraction spectra among the Gyp, 5% CAG, and 10% CAG groups. SEM images revealed that the CMC/ACP cement-based groups (5% CAG and 10% CAG) showed CMC/ACP cluster filled with hollow spaces between the gypsum crystals and aggregations surrounding the gypsum crystals. The CMC/ACP showed envelopes and attached to the crystalline structures of the gypsum. Setting times of 5% CAG and 10% CAG showed significant differences compared with Gyp (p < 0.05). CONCLUSION The result of our study showed that CMC/ACP cement-based (5% CAG and 10% CAG) demonstrated amorphous characteristic, which can stabilize calcium ions and phosphate group (ACP). In addition, the modification of gypsum using CMC/ACP as cement-based extended the time of setting.
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Affiliation(s)
- Aditya Wisnu Putranto
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Endang Suprastiwi
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Ratna Meidyawati
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Harry Agusnar
- Department of Chemistry, Faculty of Mathematics and Natural Science, Universitas Sumatera Utara, Medan, Indonesia
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Preparation and Characterization of Moldable Demineralized Bone Matrix/Calcium Sulfate Composite Bone Graft Materials. J Funct Biomater 2021; 12:jfb12040056. [PMID: 34698233 PMCID: PMC8544512 DOI: 10.3390/jfb12040056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/29/2021] [Accepted: 10/02/2021] [Indexed: 11/18/2022] Open
Abstract
Demineralized bone matrix (DBM) is a decalcified allo/xenograft retaining collagen and noncollagenous proteins, which has been extensively used because of its osteoconductive and osteoinductive properties. Calcium sulfate (CaSO4, CS) is a synthetic bone substitute used in bone healing with biocompatible, nontoxic, bioabsorbable, osteoconductive, and good mechanical characteristics. This study aims to prepare a DBM/CS composite bone graft material in a moldable putty form without compromising the peculiar properties of DBM and CS. For this purpose, firstly, porcine femur was defatted using chloroform/methanol and extracted by acid for demineralization, then freeze-dried and milled/sieved to obtain DBM powder. Secondly, the α-form and β-form of calcium sulfate hemihydrate (CaSO4·0.5H2O, CSH) were produced by heating gypsum (CaSO4·2H2O). The morphology and particle sizes of α- and β-CSH were obtained by SEM, and their chemical properties were confirmed by EDS, FTIR and XRD. Furthermore, the DBM-based graft was mixed with α- or β-CSH at a ratio of 9:1, and glycerol/4% HPMC was added as a carrier to produce a putty. DBM/CSH putty possesses a low washout rate, good mechanical strength and biocompatibility. In conclusion, we believe that the moldable DBM/CSH composite putty developed in this study could be a promising substitute for the currently available bone grafts, and might have practical application in the orthopedics field as a potential bone void filler.
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Synthetic Bone Substitutes and Mechanical Devices for the Augmentation of Osteoporotic Proximal Humeral Fractures: A Systematic Review of Clinical Studies. J Funct Biomater 2020; 11:jfb11020029. [PMID: 32380687 PMCID: PMC7353588 DOI: 10.3390/jfb11020029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/25/2020] [Accepted: 04/29/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Different augmentation techniques have been described in the literature in addition to the surgical treatment of proximal humeral fractures. The aim of this systematic review was to analyze the use of cements, bone substitutes, and other devices for the augmentation of proximal humeral fractures. METHODS A systematic review was conducted by using PubMed/MEDLINE, ISI Web of Knowledge, Cochrane Library, Scopus/EMBASE, and Google Scholar databases according the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines over the years 1966 to 2019. The search term "humeral fracture proximal" was combined with "augmentation"; "polymethylmethacrylate, PMMA"; "cement"; "bone substitutes"; "hydroxyapatite"; "calcium phosphates"; "calcium sulfate"; "cell therapies", and "tissue engineering" to find the literature relevant to the topic under review. RESULTS A total of 10 clinical studies considered eligible for the review, with a total of 308 patients, were included. Mean age at the time of injury was 68.8 years (range of 58-92). The most commonly described techniques were reinforcing the screw-bone interface with bone PMMA cement (three studies), filling the metaphyseal void with synthetic bone substitutes (five studies), and enhancing structural support with metallic devices (two studies). CONCLUSION PMMA cementation could improve screw-tip fixation. Calcium phosphate and calcium sulfate injectable composites provided good biocompatibility, osteoconductivity, and lower mechanical failure rate when compared to non-augmented fractures. Mechanical devices currently have a limited role. However, the available evidence is provided mainly by level III to IV studies, and none of the proposed techniques have been sufficiently studied.
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11
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Gurgul SJ, Seng G, Williams GR. A kinetic and mechanistic study into the transformation of calcium sulfate hemihydrate to dihydrate. JOURNAL OF SYNCHROTRON RADIATION 2019; 26:774-784. [PMID: 31074442 PMCID: PMC6510200 DOI: 10.1107/s1600577519001929] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/02/2019] [Indexed: 06/09/2023]
Abstract
The conversion of CaSO4·0.5H2O to CaSO4·2H2O is of great importance industrially, being the reaction behind plasterboard production and the setting of medical plasters. A detailed kinetic and mechanistic study of this process was conducted using time-resolved synchrotron X-ray diffraction in this work. The CaSO4·2H2O product is very similar regardless of whether the α- or β-form of CaSO4·0.5H2O is used as the starting material, but the reaction process is very different. The induction time is usually shorter for α-CaSO4·0.5H2O than β-CaSO4·0.5H2O, and a greater conversion percentage is observed with the former (although in neither case does the reaction proceed to 100% completion). The temperature of the system, widely used in industry as an indirect measure of the extent of the hydration process, is found to be a poor proxy for this, with the maximum temperature reached well before the reaction is complete. The Avrami-Erofe'ev and Gualtieri models could both be fitted to the experimental data, with the fits being substantially closer in the case of α-CaSO4·0.5H2O. The rate of reaction in the Avrami model tends to increase with the amount of gypsum seeds added to accelerate the process, and the importance of nucleation declines. The Gualtieri analysis suggested that the rate of nucleation increases substantially with the amount of seeds added, while there are less distinct changes in the rate of crystal growth. At low seed concentrations (<0.5% w/w) the rate of crystal growth is greater than the rate of nucleation, but at concentrations above 0.5% w/w nucleation is faster. These findings represent the first synchrotron study of the conversion of CaSO4·0.5H2O to CaSO4·2H2O, and will be of importance to gypsum producers globally.
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Affiliation(s)
- Sebastian J. Gurgul
- UCL School of Pharmacy, University College London, 29–39 Brunswick Square, London WC1N 1AX, UK
| | - Gabriel Seng
- Etex Group, 500 Rue Marcel Demonque, 84000 Avignon, France
| | - Gareth R. Williams
- UCL School of Pharmacy, University College London, 29–39 Brunswick Square, London WC1N 1AX, UK
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Experimental Study of the Microstructural Evolution of Glauberite and Its Weakening Mechanism under the Effect of Thermal-Hydrological-Chemical Coupling. Processes (Basel) 2018. [DOI: 10.3390/pr6080099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The microstructures of rock gradually evolve with changes in the external environment. This study focused on the microstructure evolution of glauberite and its weakening mechanism under different leaching conditions. The porosity were used as a characteristic index to study the effect of brine temperature and concentration on crack initiation and propagation in glauberite. The research subjects were specimens of ϕ3 × 10 mm cylindrical glauberite core, obtained from a bedded salt deposit buried more than 1000 m underground in the Yunying salt formation, China. The results showed that when the specimens were immersed in solution at low temperature, due to hydration impurities, cracks appeared spontaneously at the centre of the disc and the solution then penetrated the specimens via these cracks and dissolved the minerals around the crack lines. However, with an increase of temperature, the dissolution rate increased greatly, and crack nucleation and dissolved regions appeared simultaneously. When the specimens were immersed in a sodium chloride solution at the same concentration, the porosity s presented gradual upward trends with a rise in temperature, whereas, when the specimens were immersed in the sodium chloride solution at the same temperature, the porosity tended to decrease with the increase of sodium chloride concentration. In the process of leaching, the hydration of illite, montmorillonite, and the residual skeleton of glauberite led to the expansion of the specimen volume, thereby producing the cracks. The diameter expansion rate and the expansion velocity of the specimen increased with temperature increase, whereas, due to the common-ion effect, the porosity of the specimen decreases with the increase of sodium chloride solution concentration.
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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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Li S, Li H, Lv G, Duan H, Jiang D, Yan Y. Influences of degradability, bioactivity, and biocompatibility of the calcium sulfate content on a calcium sulfate/poly(amino acid) biocomposite for orthopedic reconstruction. POLYMER COMPOSITES 2015. [DOI: 10.1002/pc.23365] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Shuyang Li
- College of Physical Science and Technology, Sichuan University; Chengdu 610041 China
| | - Hong Li
- College of Physical Science and Technology, Sichuan University; Chengdu 610041 China
| | - Guoyu Lv
- College of Physical Science and Technology, Sichuan University; Chengdu 610041 China
| | - Hong Duan
- Department of Orthopedics; West China Hospital, Sichuan University; Chengdu 610041 China
| | - Dianming Jiang
- Department of Orthopedics; Chong Qing Medical University; Chong Qing 400016
| | - Yonggang Yan
- College of Physical Science and Technology, Sichuan University; Chengdu 610041 China
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Vittore D, Vicenti G, Caizzi G, Abate A, Moretti B. Balloon-assisted reduction, pin fixation and tricalcium phosphate augmentation for calcanear fracture. Injury 2014; 45 Suppl 6:S72-9. [PMID: 25457323 DOI: 10.1016/j.injury.2014.10.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Two-thirds of hindfoot fractures involve the calcaneus. The best treatment for intraarticular fractures is still debated. The goal of treatment has been focussed for years on the anatomical reduction of the articular surface. Open reduction and internal fixation enables the surgeon to view the articular surface directly, but it is associated with a high rate of wound breakdown and infection. Therefore, length, width and angular replacement of the great tuberosity are actually the main parameters to consider when treating this type of fracture. This is a report of our experience of 20 patients treated with a minimally invasive technique of reduction using an inflatable bone tamp filled with tricalcium phosphate, with a mean follow-up of 12.25 months (range 7-26 months). Percutaneous K-wires were used to help reduction and to direct balloon inflation. Surgical goals were restoration of the mechanical stability for earlier full weight-bearing and patient mobilisation.
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Affiliation(s)
- D Vittore
- Department of Neuroscience and Organs of Sense, Orthopaedic Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy
| | - G Vicenti
- Department of Neuroscience and Organs of Sense, Orthopaedic Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy.
| | - G Caizzi
- Department of Neuroscience and Organs of Sense, Orthopaedic Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy
| | - A Abate
- Department of Neuroscience and Organs of Sense, Orthopaedic Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy
| | - B Moretti
- Department of Neuroscience and Organs of Sense, Orthopaedic Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy
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Orellana BR, Puleo DA. Tailored sequential drug release from bilayered calcium sulfate composites. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 43:243-52. [PMID: 25175211 PMCID: PMC4152730 DOI: 10.1016/j.msec.2014.06.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 06/04/2014] [Accepted: 06/30/2014] [Indexed: 12/26/2022]
Abstract
The current standard for treating infected bony defects, such as those caused by periodontal disease, requires multiple time-consuming steps and often multiple procedures to fight the infection and recover lost tissue. Releasing an antibiotic followed by an osteogenic agent from a synthetic bone graft substitute could allow for a streamlined treatment, reducing the need for multiple surgeries and thereby shortening recovery time. Tailorable bilayered calcium sulfate (CS) bone graft substitutes were developed with the ability to sequentially release multiple therapeutic agents. Bilayered composite samples having a shell and core geometry were fabricated with varying amounts (1 or 10 wt.%) of metronidazole-loaded poly(lactic-co-glycolic acid) (PLGA) particles embedded in the shell and simvastatin directly loaded into either the shell, core, or both. Microcomputed tomography showed the overall layered geometry as well as the uniform distribution of PLGA within the shells. Dissolution studies demonstrated that the amount of PLGA particles (i.e., 1 vs. 10 wt.%) had a small but significant effect on the erosion rate (3% vs. 3.4%/d). Mechanical testing determined that introducing a layered geometry had a significant effect on the compressive strength, with an average reduction of 35%, but properties were comparable to those of mandibular trabecular bone. Sustained release of simvastatin directly loaded into CS demonstrated that changing the shell to core volume ratio dictates the duration of drug release from each layer. When loaded together in the shell or in separate layers, sequential release of metronidazole and simvastatin was achieved. By introducing a tunable, layered geometry capable of releasing multiple drugs, CS-based bone graft substitutes could be tailored in order to help streamline the multiple steps needed to regenerate tissue in infected defects.
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Affiliation(s)
- Bryan R Orellana
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA
| | - David A Puleo
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA.
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17
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Consolidation of archaeological gypsum plaster by bacterial biomineralization of calcium carbonate. Acta Biomater 2014; 10:3844-54. [PMID: 24657676 DOI: 10.1016/j.actbio.2014.03.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 03/06/2014] [Accepted: 03/10/2014] [Indexed: 11/24/2022]
Abstract
Gypsum plasterworks and decorative surfaces are easily degraded, especially when exposed to humidity, and thus they require protection and/or consolidation. However, the conservation of historical gypsum-based structural and decorative materials by conventional organic and inorganic consolidants shows limited efficacy. Here, a new method based on the bioconsolidation capacity of carbonatogenic bacteria inhabiting the material was assayed on historical gypsum plasters and compared with conventional consolidation treatments (ethyl silicate; methylacrylate-ethylmethacrylate copolymer and polyvinyl butyral). Conventional products do not reach in-depth consolidation, typically forming a thin impervious surface layer which blocks pores. In contrast, the bacterial treatment produces vaterite (CaCO3) biocement, which does not block pores and produces a good level of consolidation, both at the surface and in-depth, as shown by drilling resistance measurement system analyses. Transmission electron microscopy analyses show that bacterial vaterite cement formed via oriented aggregation of CaCO3 nanoparticles (∼20nm in size), resulting in mesocrystals which incorporate bacterial biopolymers. Such a biocomposite has superior mechanical properties, thus explaining the fact that drilling resistance of bioconsolidated gypsum plasters is within the range of inorganic calcite materials of equivalent porosity, despite the fact that the bacterial vaterite cement accounts for only a 0.02 solid volume fraction. Bacterial bioconsolidation is proposed for the effective consolidation of this type of material. The potential applications of bacterial calcium carbonate consolidation of gypsum biomaterials used as bone graft substitutes are discussed.
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Orellana BR, Hilt JZ, Puleo DA. Drug release from calcium sulfate-based composites. J Biomed Mater Res B Appl Biomater 2014; 103:135-42. [PMID: 24788686 DOI: 10.1002/jbm.b.33181] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 03/11/2014] [Accepted: 04/05/2014] [Indexed: 12/24/2022]
Abstract
To help reduce the need for autografts, calcium sulfate (CS)-based bone graft substitutes are being developed to provide a stable platform to aid augmentation while having the ability to release a broad range of bioactive agents. CS has an excellent reputation as a biocompatible and osteoconductive substance, but addition of bioactive agents may further enhance these properties. Samples were produced with either directly loaded small, hydrophobic molecule (i.e., simvastatin), directly loaded hydrophilic protein (i.e., lysozyme), or 1 and 10 wt % of fast-degrading poly(β-amino ester) (PBAE) particles containing protein. Although sustained release of directly loaded simvastatin was achieved, direct loading of small amounts of lysozyme resulted in highly variable release. Direct loading of a larger amount of protein generated a large burst, 65% of total loading, followed by sustained release of protein. Release of lysozyme from 1 wt % of PBAE particles embedded into CS was more controllable than when directly loaded, and for 10 wt % of protein-loaded PBAE particles, a higher burst was followed by sustained release, comparable to the results for the high direct loading. Compression testing determined that incorporation of directly loaded drug or drug-loaded PBAE particles weakened CS. In particular, PBAE particles had a significant effect on the strength of the composites, with a 25 and 80% decrease in strength for 1 and 10 wt % particle loadings, respectively. CS-based composites demonstrated the ability to sustainably release both macromolecules and small molecules, supporting the potential for these materials to release a range of therapeutic agents.
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Affiliation(s)
- Bryan R Orellana
- Department of Biomedical Engineering, University of Kentucky, Lexington, Kentucky
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Orellana BR, Thomas MV, Dziubla TD, Shah NM, Hilt JZ, Puleo DA. Bioerodible calcium sulfate/poly(β-amino ester) hydrogel composites. J Mech Behav Biomed Mater 2013; 26:43-53. [PMID: 23811276 PMCID: PMC3713170 DOI: 10.1016/j.jmbbm.2013.05.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 05/13/2013] [Accepted: 05/18/2013] [Indexed: 11/21/2022]
Abstract
The capacity to quickly regenerate or augment bone lost as a result of resorption is crucial to ensure suitable application of prosthetics for restoring masticatory function. Calcium sulfate hemihydrate (CS)-based bone graft substitute composites containing poly(β-amino ester) (PBAE) biodegradable hydrogel particles were developed to act as a 'tenting' barrier to soft tissue infiltration, potentially providing adequate space to enable vertical bone regeneration. CS has long been recognized as an osteoconductive biomaterial with an excellent reputation as a biocompatible substance. Composite samples were fabricated with varying amounts (1 or 10 wt%) and sizes (53-150 or 150-250 μm) of gel particles embedded in CS. The swelling and degradation rates of PBAE gels alone were rapid, resulting in complete degradation in less than 24h, an important characteristic to aid in controlled release of drug. MicroCT images revealed a homogeneous distribution of gel particles within the CS matrix. All CS samples degraded via surface erosion, with the amount of gel particles (i.e., 10 wt% gel particles) having only a small, but significant, effect on the dissolution rate (4% vs. 5% per day). Compression testing determined that the amount, but not the size, of gel particles had a significant effect on the overall strength of the composites. As much as a 75% drop in strength was seen with a 10 wt% loading of particles. A pilot study using PBAE particles loaded with the multipotential drug curcumin demonstrated sustained release of drug from CS composites. By adjusting the amount and/or size of the biodegradable gel particles embedded in CS, mechanical strength and degradation rates of the composites, as well as the drug release kinetics, can be tuned to fabricate, multi-functional 'space-making' bone grafting substitutes.
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Affiliation(s)
- Bryan R. Orellana
- Center for Biomedical Engineering, Wenner-Gren Research Lab, University of Kentucky, Lexington, KY 40506-0070, USA
| | - Mark V. Thomas
- College of Dentistry, University of Kentucky, Lexington, KY 40536-0297, USA
| | - Thomas D. Dziubla
- Department of Chemical and Materials Engineering, University of Kentucky, Lexington, KY 40506-0046, USA
| | - Nihar M. Shah
- Department of Chemical and Materials Engineering, University of Kentucky, Lexington, KY 40506-0046, USA
| | - James Z. Hilt
- Department of Chemical and Materials Engineering, University of Kentucky, Lexington, KY 40506-0046, USA
| | - David A. Puleo
- Center for Biomedical Engineering, Wenner-Gren Research Lab, University of Kentucky, Lexington, KY 40506-0070, USA
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20
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Ma J, Granton PV, Holdsworth DW, Turley EA. Oral administration of hyaluronan reduces bone turnover in ovariectomized rats. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2013; 61:339-345. [PMID: 23256527 DOI: 10.1021/jf300651d] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The effect of oral hyaluronan (HA) on bone loss in ovariectomized (OVX) 3-month-old rats was measured using serum markers of bone turnover and bone mineral density. OVX rats were administered 1 mg/kg HA (OVX + HA) or phosphate-buffered saline (PBS) (OVX + PBS) by oral gavage (5 days/week for 54 days). Additional controls included sham ovariectomy with PBS gavage (Sham + PBS) and no treatment. Oral administration of HA resulted in approximately 50% (p < 0.05) increases in serum HA. Gel filtration analyses showed this was high molecular weight HA (300-500 kDa). Osteopenia was mild due to the young age of the animals. Thus, ovariectomy resulted in a 30% increase in serum collagen N-terminal telopeptides (p < 0.001), a 20% increase in serum nitrate/nitrite levels (p = 0.05), and a 5-6% decrease in femur bone mineral density/content (p < 0.05). HA gavage blunted the development of osteopenia in this model as determined by preventing the 30% increase in serum collagen N-terminal telopeptide levels (p < 0.001) and by reducing bone mineral content loss from 6 to 4%. These results show that oral supplements of HA (gavage solution, 0.12% solution) significantly reduce bone turnover associated with mild osteopenia in rats.
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MESH Headings
- Administration, Oral
- Animals
- Biomarkers/blood
- Biomarkers/metabolism
- Bone Density
- Bone Density Conservation Agents/administration & dosage
- Bone Density Conservation Agents/blood
- Bone Density Conservation Agents/metabolism
- Bone Density Conservation Agents/therapeutic use
- Bone Diseases, Metabolic/blood
- Bone Diseases, Metabolic/etiology
- Bone Diseases, Metabolic/metabolism
- Bone Diseases, Metabolic/prevention & control
- Bone Remodeling
- Dietary Supplements
- Female
- Humans
- Hyaluronic Acid/administration & dosage
- Hyaluronic Acid/blood
- Hyaluronic Acid/metabolism
- Hyaluronic Acid/therapeutic use
- Osteoporosis, Postmenopausal/blood
- Osteoporosis, Postmenopausal/etiology
- Osteoporosis, Postmenopausal/metabolism
- Osteoporosis, Postmenopausal/prevention & control
- Ovariectomy/adverse effects
- Rats
- Rats, Sprague-Dawley
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Affiliation(s)
- Jenny Ma
- London Regional Cancer Program, London Health Sciences Center, Victoria Hospital, and Department of Biochemistry and Oncology, University of Western Ontario, London, Ontario, Canada
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Improving biodegradation behavior of calcium sulfate bone graft tablet by using water vapor treatment. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2013; 33:121-6. [DOI: 10.1016/j.msec.2012.08.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Revised: 06/16/2012] [Accepted: 08/10/2012] [Indexed: 11/18/2022]
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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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23
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Brown ME, Zou Y, Dziubla TD, Puleo DA. Effects of composition and setting environment on mechanical properties of a composite bone filler. J Biomed Mater Res A 2012; 101:973-80. [DOI: 10.1002/jbm.a.34399] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 07/30/2012] [Accepted: 07/31/2012] [Indexed: 11/12/2022]
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Li Z, Kong W, Li X, Xu C, He Y, Gao J, Ma Z, Wang X, Zhang Y, Xing F, Li M, Liu Y. Antibiotic-Containing Biodegradable Bead Clusters with Porous PLGA Coating as Controllable Drug-Releasing Bone Fillers. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2012; 22:1713-31. [PMID: 20836923 DOI: 10.1163/092050610x521603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Zhiliang Li
- a School of Science, Tianjin University, Tianjin 300072, P. R. China
| | - Weina Kong
- b School of Science, Tianjin University, Tianjin 300072, P. R. China
| | - Xiulan Li
- c Tianjin Orthopedic Hospital, Tianjin 300211, P. R. China
| | - Chen Xu
- d Beijing 302 Hospital, Beijing 300060, P. R. China
| | - Yongqiang He
- e School of Science, Tianjin University, Tianjin 300072, P. R. China
| | - Jianping Gao
- f School of Science, Tianjin University, Tianjin 300072, P. R. China
| | - Zhiqing Ma
- g School of Science, Tianjin University, Tianjin 300072, P. R. China
| | - Xiaodong Wang
- h School of Science, Tianjin University, Tianjin 300072, P. R. China
| | - Yang Zhang
- i Tianjin Orthopedic Hospital, Tianjin 300211, P. R. China
| | - Fubao Xing
- j School of Science, Tianjin University, Tianjin 300072, P. R. China
| | - Min Li
- k School of Science, Tianjin University, Tianjin 300072, P. R. China
| | - Yu Liu
- l School of Science, Tianjin University, Tianjin 300072, P. R. China.
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Evaluation of ABM/P-15 versus autogenous bone in an ovine lumbar interbody fusion model. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2010; 19:2156-63. [PMID: 20694847 DOI: 10.1007/s00586-010-1546-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Revised: 06/15/2010] [Accepted: 07/25/2010] [Indexed: 10/19/2022]
Abstract
A prospective, randomized study was performed in an ovine model to compare the efficacy of an anorganic bovine-derived hydroxyapatite matrix combined with a synthetic 15 amino acid residue (ABM/P-15) in facilitating lumbar interbody fusion when compared with autogenous bone harvested from the iliac crest. P-15 is a biomimetic to the cell-binding site of Type-I collagen for bone-forming cells. When combined with ABM, it creates the necessary scaffold to initiate cell invasion, binding, and subsequent osteogenesis. In this study, six adult ewes underwent anterior-lateral interbody fusion at L3/L4 and L4/L5 using PEEK interbody rings filled with autogenous bone at one level and ABM/P-15 at the other level and no additional instrumentation. Clinical CT scans were obtained at 3 and 6 months; micro-CT scans and histomorphometry analyses were performed after euthanization at 6 months. Clinical CT scan analysis showed that all autograft and ABM/P-15 treated levels had radiographically fused outside of the rings at the 3-month study time point. Although the clinical CT scans of the autograft treatment group showed significantly better fusion within the PEEK rings than ABM/P-15 at 3 months, micro-CT scans, clinical CT scans, and histomorphometric analyses showed there were no statistical differences between the two treatment groups at 6 months. Thus, ABM/P-15 was as successful as autogenous bone graft in producing lumbar spinal fusion in an ovine model, and it should be further evaluated in clinical studies.
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Woo KM, Yu B, Jung HM, Lee YK. Comparative evaluation of different crystal-structured calcium sulfates as bone-filling materials. J Biomed Mater Res B Appl Biomater 2009; 91:545-554. [PMID: 19507143 DOI: 10.1002/jbm.b.31428] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The mechanical and handling properties and biological performances of two types of calcium sulfate (betaCS and alphaCS) as bone-filling materials were compared. The influence of two modifiers such as hydroxypropylmethylcellose (HPMC) and fibrin was also examined. alphaCS showed higher strength than, and similar setting time and injectability to those of betaCS. The degradation of CS in a simulated body fluid (SBF) was checked by measuring the amount of calcium released to SBF. alphaCS showed reduced calcium release than betaCS. The modifiers tended to increase the calcium release. The MC3T3-E1 preosteoblasts cultured on alphaCS showed higher levels of alkaline phosphatase (ALP) activity than those cultured on betaCS. alphaCS strongly promoted gene expression of osteoblast phenotypes including Runx2, alpha1(I) collagen, osteocalcin, and bone sialoprotein. There was no significant difference in cell adhesion and proliferation between two types of CS. The addition of modifiers to CS increased cell proliferation, ALP activity, and the gene expression. The osteoclastic differentiation of RAW264.7 monocytes was checked. The cells on both types of CS produced tartrate-resistant acid phosphatase (TRAP) activity with no significant difference. These cell response results indicated that alphaCS promoted osteoblast differentiation over betaCS but not osteoclast differentiation. Conclusively, a particular form of commercially available alphaCS possesses superior properties to betaCS in terms of mechanical properties and supports for osteoblast differentiation, suggesting that alphaCS could be an alternative to the conventionally used betaCS. The addition of HPMC and fibrin could further improve the feasibility of alphaCS as a bone-filling material.
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Affiliation(s)
- Kyung Mi Woo
- Department of Cell and Developmental Biology, Dental Research Institute and BK21 Program, School of Dentistry, Seoul National University, Seoul 110-749, Republic of Korea
| | - Bin Yu
- Department of Dental Biomaterials Science, Dental Research Institute and BK21 Program, School of Dentistry, Seoul National University, Seoul 110-749, Republic of Korea
| | - Hong-Moon Jung
- Department of Cell and Developmental Biology, Dental Research Institute and BK21 Program, School of Dentistry, Seoul National University, Seoul 110-749, Republic of Korea
| | - Yong-Keun Lee
- Department of Dental Biomaterials Science, Dental Research Institute and BK21 Program, School of Dentistry, Seoul National University, Seoul 110-749, Republic of Korea
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27
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Thomas MV, Puleo DA. Calcium sulfate: Properties and clinical applications. J Biomed Mater Res B Appl Biomater 2009; 88:597-610. [DOI: 10.1002/jbm.b.31269] [Citation(s) in RCA: 211] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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28
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An In Vivo Comparative Analysis of the Intra-Operative Properties of Injectable Calcium Phosphate/Calcium Sulphate Based Bone Cements. ACTA ACUST UNITED AC 2007. [DOI: 10.4028/www.scientific.net/kem.330-332.799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The aim of this work was to assess the mixing, transfer and handling, properties,
injectability, set time, wash-out characteristics, acceptance of hardware (i.e. stainless screws), and
their delivery/transfer systems of self hardening synthetic bone cements made from calcium
phosphate and calcium sulphate. Surgical procedures (i.e. cranioplasty) were performed on adult
Labrador dogs using seven different bone cements from various manufacturers. Direct comparison
of the defined intraoperative properties were evaluated and recorded. There is considerable
variability with respect to application properties among commercially available injectable synthetic
bone cements. Only one product was rated good to excellent in seven of the eight categories
evaluated (6-excellent, 1-good, 1-fair) based on in-vivo tests. This study outlines the critical
parameters required for successful implantation of cements that have to be understood when
designing new injectable bone cements for the future.
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