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Steinacker VC, Renner T, Holzmeister I, Gubik S, Müller-Richter U, Breitenbücher N, Fuchs A, Straub A, Scheurer M, Kübler AC, Gbureck U. Biological and Mechanical Performance of Dual-Setting Brushite-Silica Gel Cements. J Funct Biomater 2024; 15:108. [PMID: 38667565 PMCID: PMC11051121 DOI: 10.3390/jfb15040108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/09/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Bone defects resulting from trauma, diseases, or surgical procedures pose significant challenges in the field of oral and maxillofacial surgery. The development of effective bone substitute materials that promote bone healing and regeneration is crucial for successful clinical outcomes. Calcium phosphate cements (CPCs) have emerged as promising candidates for bone replacement due to their biocompatibility, bioactivity, and ability to integrate with host tissues. However, there is a continuous demand for further improvements in the mechanical properties, biodegradability, and bioactivity of these materials. Dual setting of cements is one way to improve the performance of CPCs. Therefore, silicate matrices can be incorporated in these cements. Silicate-based materials have shown great potential in various biomedical applications, including tissue engineering and drug delivery systems. In the context of bone regeneration, silicate matrices offer unique advantages such as improved mechanical stability, controlled release of bioactive ions, and enhanced cellular responses. Comprehensive assessments of both the material properties and biological responses of our samples were conducted. Cytocompatibility was assessed through in vitro testing using osteoblastic (MG-63) and osteoclastic (RAW 264.7) cell lines. Cell activity on the surfaces was quantified, and scanning electron microscopy (SEM) was employed to capture images of the RAW cells. In our study, incorporation of tetraethyl orthosilicate (TEOS) in dual-curing cements significantly enhanced physical properties, attributed to increased crosslinking density and reduced pore size. Higher alkoxysilyl group concentration improved biocompatibility by facilitating greater crosslinking. Additionally, our findings suggest citrate's potential as an alternative retarder due to its positive interaction with the silicate matrix, offering insights for future dental material research. This paper aims to provide an overview of the importance of silicate matrices as modifiers for calcium phosphate cements, focusing on their impact on the mechanical properties, setting behaviour, and biocompatibility of the resulting composites.
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Affiliation(s)
- Valentin C. Steinacker
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Tobias Renner
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Ib Holzmeister
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Sebastian Gubik
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Urs Müller-Richter
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Niko Breitenbücher
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Andreas Fuchs
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Anton Straub
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Mario Scheurer
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, 89081 Ulm, Germany
| | - Alexander C. Kübler
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
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Miron RJ, Fujioka-Kobayashi M, Pikos MA, Nakamura T, Imafuji T, Zhang Y, Shinohara Y, Sculean A, Shirakata Y. The development of non-resorbable bone allografts: Biological background and clinical perspectives. Periodontol 2000 2024; 94:161-179. [PMID: 38323368 DOI: 10.1111/prd.12551] [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] [Received: 09/04/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 02/08/2024]
Abstract
Bone grafts are typically categorized into four categories: autografts, allografts, xenografts, and synthetic alloplasts. While it was originally thought that all bone grafts should be slowly resorbed and replaced with native bone over time, accumulating evidence has in fact suggested that the use of nonresorbable xenografts is favored for certain clinical indications. Thus, many clinicians take advantage of the nonresorbable properties/features of xenografts for various clinical indications, such as contour augmentation, sinus grafting, and guided bone regeneration, which are often combined with allografts (e.g., human freeze-dried bone allografts [FDBAs] and human demineralized freeze-dried bone allografts [DFDBAs]). Thus, many clinicians have advocated different 50/50 or 70/30 ratios of allograft/xenograft combination approaches for various grafting procedures. Interestingly, many clinicians believe that one of the main reasons for the nonresorbability or low substitution rates of xenografts has to do with their foreign animal origin. Recent research has indicated that the sintering technique and heating conducted during their processing changes the dissolution rate of hydroxyapatite, leading to a state in which osteoclasts are no longer able to resorb (dissolve) the sintered bone. While many clinicians often combine nonresorbable xenografts with the bone-inducing properties of allografts for a variety of bone augmentation procedures, clinicians are forced to use two separate products owing to their origins (the FDA/CE does not allow the mixture of allografts with xenografts within the same dish/bottle). This has led to significant progress in understanding the dissolution rates of xenografts at various sintering temperature changes, which has since led to the breakthrough development of nonresorbable bone allografts sintered at similar temperatures to nonresorbable xenografts. The advantage of the nonresorbable bone allograft is that they can now be combined with standard allografts to create a single mixture combining the advantages of both allografts and xenografts while allowing the purchase and use of a single product. This review article presents the concept with evidence derived from a 52-week monkey study that demonstrated little to no resorption along with in vitro data supporting this novel technology as a "next-generation" biomaterial with optimized bone grafting material properties.
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Affiliation(s)
- Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Masako Fujioka-Kobayashi
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | | | - Toshiaki Nakamura
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takatomo Imafuji
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yufeng Zhang
- Department of Oral Implantology, University of Wuhan, Wuhan, China
| | - Yukiya Shinohara
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Yoshinori Shirakata
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Wang Z, Geest ICMVD, Leeuwenburgh SCG, van den Beucken JJJP. Bifunctional bone substitute materials for bone defect treatment after bone tumor resection. Mater Today Bio 2023; 23:100889. [PMID: 38149015 PMCID: PMC10749907 DOI: 10.1016/j.mtbio.2023.100889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/27/2023] [Accepted: 11/27/2023] [Indexed: 12/28/2023] Open
Abstract
Aggressive benign, malignant and metastatic bone tumors can greatly decrease the quality of patients' lives and even lead to substantial mortality. Several clinical therapeutic strategies have been developed to treat bone tumors, including preoperative chemotherapy, surgical resection of the tumor tissue, and subsequent systemic chemo- or radiotherapy. However, those strategies are associated with inevitable drawbacks, such as severe side effects, substantial local tumor recurrence, and difficult-to-treat bone defects after tumor resection. To overcome these shortcomings and achieve satisfactory clinical outcomes, advanced bifunctional biomaterials which simultaneously promote bone regeneration and combat bone tumor growth are increasingly advocated. These bifunctional bone substitute materials fill bone defects following bone tumor resection and subsequently exert local anticancer effects. Here we describe various types of the most prevalent bone tumors and provide an overview of common treatment options. Subsequently, we review current progress regarding the development of bifunctional bone substitute materials combining osteogenic and anticancer efficacy. To this end, we categorize these biomaterials based on their anticancer mechanism deriving from i) intrinsic biomaterial properties, ii) local drug release of anticancer agents, and iii) oxidative stress-inducing and iv) hyperthermia-inducing biomaterials. Consequently, this review offers researchers, surgeons and oncologists an up-to-date overview of our current knowledge on bone tumors, their treatment options, and design of advanced bifunctional biomaterials with strong potential for clinical application in oncological orthopedics.
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Affiliation(s)
- Zhule Wang
- Radboud University Medical Center, Department of Dentistry – Regenerative Biomaterials, Nijmegen, the Netherlands
- Research Institute for Medical Innovation, Radboudumc, Nijmegen, the Netherlands
| | - Ingrid CM van der Geest
- Research Institute for Medical Innovation, Radboudumc, Nijmegen, the Netherlands
- Radboud University Medical Center, Department of Orthopedics, Nijmegen, the Netherlands
| | - Sander CG. Leeuwenburgh
- Radboud University Medical Center, Department of Dentistry – Regenerative Biomaterials, Nijmegen, the Netherlands
- Research Institute for Medical Innovation, Radboudumc, Nijmegen, the Netherlands
| | - Jeroen JJP. van den Beucken
- Radboud University Medical Center, Department of Dentistry – Regenerative Biomaterials, Nijmegen, the Netherlands
- Research Institute for Medical Innovation, Radboudumc, Nijmegen, the Netherlands
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Schröter L, Kaiser F, Preißler AL, Wohlfahrt P, Küppers O, Gbureck U, Ignatius A. Ready-To-Use and Rapidly Biodegradable Magnesium Phosphate Bone Cement: In Vivo Evaluation in Sheep. Adv Healthc Mater 2023; 12:e2300914. [PMID: 37224104 DOI: 10.1002/adhm.202300914] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/16/2023] [Indexed: 05/26/2023]
Abstract
In clinical practice, hydroxyapatite (HA) cements for bone defect treatment are frequently prepared by mixing a powder component and a liquid component shortly before implantation in the operation theater, which is time-consuming and error-prone. In addition, HA cements are only slightly resorbed, that is, cement residues can still be found in the bone years after implantation. Here, these challenges are addressed by a prefabricated magnesium phosphate cement paste based on glycerol, which is ready-to-use and can be directly applied during surgery. By using a trimodal particle size distribution (PSD), the paste is readily injectable and exhibits a compressive strength of 9-14 MPa after setting. Struvite (MgNH4 PO4 ·6H2 O), dittmarite (MgNH4 PO4 ·H2 O), farringtonite (Mg3 (PO4 )2 ), and newberyite (MgHPO4 ·3H2 O) are the mineral phases present in the set cement. The paste developed here features a promising degradation of 37% after four months in an ovine implantation model, with 25% of the implant area being newly formed bone. It is concluded that the novel prefabricated paste improves application during surgery, has a suitable degradation rate, and supports bone regeneration.
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Affiliation(s)
- Lena Schröter
- Institute for Orthopedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081, Ulm, Germany
| | - Friederike Kaiser
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070, Würzburg, Germany
| | - Anna-Lena Preißler
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070, Würzburg, Germany
| | - Philipp Wohlfahrt
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070, Würzburg, Germany
| | - Oliver Küppers
- Institute for Orthopedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081, Ulm, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070, Würzburg, Germany
| | - Anita Ignatius
- Institute for Orthopedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081, Ulm, Germany
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Ewald A, Fuchs A, Boegelein L, Grunz JP, Kneist K, Gbureck U, Hoelscher-Doht S. Degradation and Bone-Contact Biocompatibility of Two Drillable Magnesium Phosphate Bone Cements in an In Vivo Rabbit Bone Defect Model. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4650. [PMID: 37444964 DOI: 10.3390/ma16134650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/15/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023]
Abstract
The use of bone-cement-enforced osteosynthesis is a growing topic in trauma surgery. In this context, drillability is a desirable feature for cements that can improve fracture stability, which most of the available cement systems lack. Therefore, in this study, we evaluated a resorbable and drillable magnesium-phosphate (MgP)-based cement paste considering degradation behavior and biocompatibility in vivo. Two different magnesium-phosphate-based cement (MPC) pastes with different amounts of phytic acid (IP 6) as setting retarder (MPC 22.5 and MPC 25) were implanted in an orthotopic defect model of the lateral femoral condyle of New Zealand white rabbits for 6 weeks. After explantation, their resorption behavior and material characteristics were evaluated by means of X-ray diffraction (XRD), porosimetry measurement, histological staining, peripheral quantitative computed tomography (pQCT), cone-beam computed tomography (CBCT) and biomechanical load-to-failure tests. Both cement pastes displayed comparable results in mechanical strength and resorption kinetics. Bone-contact biocompatibility was excellent without any signs of inflammation. Initial resorption and bone remodeling could be observed. MPC pastes with IP 6 as setting retardant have the potential to be a valuable alternative in distinct fracture patterns. Drillability, promising resorption potential and high mechanical strength confirm their suitability for use in clinical routine.
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Affiliation(s)
- Andrea Ewald
- Department for Functional Materials in Medicine and Dentistry, University Hospital of Wuerzburg, Pleicherwall 2, 97070 Wuerzburg, Germany
| | - Andreas Fuchs
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital of Wuerzburg, Pleicherwall 2, 97070 Wuerzburg, Germany
| | - Lasse Boegelein
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of Wuerzburg, Oberduerrbacher Street 6, 97080 Wuerzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital of Wuerzburg, Oberduerrbacher Street 6, 97080 Wuerzburg, Germany
| | - Karl Kneist
- Department for Functional Materials in Medicine and Dentistry, University Hospital of Wuerzburg, Pleicherwall 2, 97070 Wuerzburg, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital of Wuerzburg, Pleicherwall 2, 97070 Wuerzburg, Germany
| | - Stefanie Hoelscher-Doht
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of Wuerzburg, Oberduerrbacher Street 6, 97080 Wuerzburg, Germany
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Qin C, Che D, Liu D, Zhang Z, Feng Y. Preparation and characterization of different micro/nano structures on the surface of bredigite scaffolds. Sci Rep 2023; 13:9072. [PMID: 37277439 PMCID: PMC10241911 DOI: 10.1038/s41598-023-36382-z] [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] [Received: 02/21/2023] [Accepted: 06/02/2023] [Indexed: 06/07/2023] Open
Abstract
The preparation of controllable micro/nano structures on the surface of the bredigite scaffold is expected to exhibit the same support and osteoconductive capabilities as living bone. However, the hydrophobicity of the white calciμm silicate scaffold surface restricts the adhesion and spreading of osteoblasts. Furthermore, during the degradation process of the bredigite scaffold, the release of Ca2+ results in an alkaline environment around the scaffold, which inhibits the growth of osteoblasts. In this study, the three-dimensional geometry of the Primitive surface in the three-periodic minimal surface with an average curvature of 0 was used as the basis for the scaffold unit cell, and a white hydroxyapatite scaffold was fabricated via photopolymerization-based 3D printing. Nanoparticles, microparticles, and micro-sheet structures with thicknesses of 6 μm, 24 μm, and 42 μm, respectively, were prepared on the surface of the porous scaffold through a hydrothermal reaction. The results of the study indicate that the micro/nano surface did not affect the morphology and mineralization ability of the macroporous scaffold. However, the transition from hydrophobic to hydrophilic resulted in a rougher surface and an increase in compressive strength from 45 to 59-86 MPa, while the adhesion of the micro/nano structures enhanced the scaffold's ductility. In addition, after 8 days of degradation, the pH of the degradation solution decreased from 8.6 to around 7.6, which is more suitable for cell growth in the hμman body. However, there were issues of slow degradation and high P element concentration in the degradation solution for the microscale layer group during the degradation process, so the nanoparticle and microparticle group scaffolds could provide effective support and a suitable environment for bone tissue repair.
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Affiliation(s)
- Changcai Qin
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, China
- Shandong Institute of Mechanical Design and Research, jinan, China
| | - Dezhao Che
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, China
- Shandong Institute of Mechanical Design and Research, jinan, China
| | - Dongxue Liu
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, China
- Shandong Institute of Mechanical Design and Research, jinan, China
| | - Zefei Zhang
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, China
- Shandong Institute of Mechanical Design and Research, jinan, China
| | - Yihua Feng
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, China.
- Shandong Institute of Mechanical Design and Research, jinan, China.
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Lukina Y, Safronova T, Smolentsev D, Toshev O. Calcium Phosphate Cements as Carriers of Functional Substances for the Treatment of Bone Tissue. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4017. [PMID: 37297151 PMCID: PMC10254876 DOI: 10.3390/ma16114017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/14/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
Interest in calcium phosphate cements as materials for the restoration and treatment of bone tissue defects is still high. Despite commercialization and use in the clinic, the calcium phosphate cements have great potential for development. Existing approaches to the production of calcium phosphate cements as drugs are analyzed. A description of the pathogenesis of the main diseases of bone tissue (trauma, osteomyelitis, osteoporosis and tumor) and effective common treatment strategies are presented in the review. An analysis of the modern understanding of the complex action of the cement matrix and the additives and drugs distributed in it in relation to the successful treatment of bone defects is given. The mechanisms of biological action of functional substances determine the effectiveness of use in certain clinical cases. An important direction of using calcium phosphate cements as a carrier of functional substances is the volumetric incorporation of anti-inflammatory, antitumor, antiresorptive and osteogenic functional substances. The main functionalization requirement for carrier materials is prolonged elution. Various release factors related to the matrix, functional substances and elution conditions are considered in the work. It is shown that cements are a complex system. Changing one of the many initial parameters in a wide range changes the final characteristics of the matrix and, accordingly, the kinetics. The main approaches to the effective functionalization of calcium phosphate cements are considered in the review.
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Affiliation(s)
- Yulia Lukina
- National Medical Research Center for Traumatology and Orthopedics Named after N.N. Priorov, Ministry of Health of the Russian Federation, Priorova 10, 127299 Moscow, Russia;
- Faculty of Digital Technologies and Chemical Engineering, Mendeleev University of Chemical Technology of Russia, Miusskaya pl. 9, 125047 Moscow, Russia
| | - Tatiana Safronova
- Department of Chemistry, Lomonosov Moscow State University, Building 3, Leninskie Gory 1, 119991 Moscow, Russia;
- Department of Materials Science, Lomonosov Moscow State University, Building 73, Leninskie Gory 1, 119991 Moscow, Russia;
| | - Dmitriiy Smolentsev
- National Medical Research Center for Traumatology and Orthopedics Named after N.N. Priorov, Ministry of Health of the Russian Federation, Priorova 10, 127299 Moscow, Russia;
| | - Otabek Toshev
- Department of Materials Science, Lomonosov Moscow State University, Building 73, Leninskie Gory 1, 119991 Moscow, Russia;
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Li S, Zhang L, Liu C, Kim J, Su K, Chen T, Zhao L, Lu X, Zhang H, Cui Y, Cui X, Yuan F, Pan H. Spontaneous immunomodulation and regulation of angiogenesis and osteogenesis by Sr/Cu-borosilicate glass (BSG) bone cement to repair critical bone defects. Bioact Mater 2023; 23:101-117. [DOI: 10.1016/j.bioactmat.2022.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022] Open
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Calcium phosphate bone cements as local drug delivery systems for bone cancer treatment. BIOMATERIALS ADVANCES 2023; 148:213367. [PMID: 36921461 DOI: 10.1016/j.bioadv.2023.213367] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/18/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023]
Abstract
Bone cancer is usually a metastatic disease, affecting people of all ages. Its effective therapy requires a targeted drug administration locally at the cancer site so that the surrounding healthy organs and tissues stay unharmed. Upon a thorough literature search, a tremendous number of published articles are reporting on development of calcium phosphate cements (CPCs) for the treatment of a variety of diseases, such as osteoporosis, osteoarthritis, osteomyelitis, and other musculoskeletal disorders. However, just a limited number of research employs CPCs specifically for bone cancer treatment. In this review article, we study the factors influencing the local drug release from CPCs and particularly focus on bone cancer therapy. Finally, we locate the deficiencies in the literature regarding this specific topic and propose which other perspectives should be considered and discussed in future articles.
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Nandi SK, Roy M, Bandyopadhyay A, Bose S. In vivo biocompatibility of SrO and MgO doped brushite cements. J Biomed Mater Res B Appl Biomater 2023; 111:599-609. [PMID: 36254886 PMCID: PMC9852027 DOI: 10.1002/jbm.b.35177] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/13/2022] [Accepted: 09/27/2022] [Indexed: 01/22/2023]
Abstract
The addition of dopants in biomaterials has emerged as a critical regulator of bone formation and regeneration due to their imminent role in the biological process. The present work evaluated the role of strontium (Sr) and magnesium (Mg) dopants in brushite cement (BrC) on in vivo bone healing performance in a rabbit model. Pure, 1 wt% SrO (Sr-BrC), 1 wt% MgO (Mg-BrC), and a binary composition of 1.0 wt% SrO + 1.0 wt% MgO (Sr + Mg-BrC) BrCs were implanted into critical-sized tibial defects in rabbits for up to 4 months. The in vivo bone healing of three doped and pure BrC samples was examined and compared using sequential radiological examination, histological evaluations, and fluorochrome labeling studies. The results indicated excellent osseous tissue formation for Sr-BrC and Sr + Mg-BrC and moderate bone regeneration for Mg-BrC compared to pure BrC. Our findings indicated that adding small amounts of SrO, MgO, and binary dopants to the BrC can significantly influence new bone formation for bone tissue engineering.
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Affiliation(s)
- Samit K. Nandi
- Department of Veterinary Surgery and RadiologyWest Bengal University of Animal and Fishery SciencesKolkataIndia
| | - Mangal Roy
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials EngineeringWashington State UniversityPullmanWashingtonUSA
- Present address:
Metallurgical and Materials EngineeringIIT‐KharagpurKharagpurIndia
| | - Amit Bandyopadhyay
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials EngineeringWashington State UniversityPullmanWashingtonUSA
| | - Susmita Bose
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials EngineeringWashington State UniversityPullmanWashingtonUSA
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Biodegradable Cements for Bone Regeneration. J Funct Biomater 2023; 14:jfb14030134. [PMID: 36976058 PMCID: PMC10056236 DOI: 10.3390/jfb14030134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/08/2023] Open
Abstract
Bone cements such as polymethyl methacrylate and calcium phosphates have been widely used for the reconstruction of bone. Despite their remarkable clinical success, the low degradation rate of these materials hampers a broader clinical use. Matching the degradation rate of the materials with neo bone formation remains a challenge for bone-repairing materials. Moreover, questions such as the mechanism of degradation and how the composition of the materials contribute to the degradation property remain unanswered. Therefore, the review provides an overview of currently used biodegradable bone cements such as calcium phosphates (CaP), calcium sulfates and organic-inorganic composites. The possible degradation mechanism and clinical performance of the biodegradable cements are summarized. This paper reviews up-to-date research and applications of biodegradable cements, hoping to provide researchers in the field with inspirations and references.
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Injection of a Bone Substitute in the Treatment of Unicameral Bone Cysts. Adv Orthop 2023; 2023:3270372. [PMID: 36643872 PMCID: PMC9836794 DOI: 10.1155/2023/3270372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
Background Simple bone cysts are benign bony lesions. Treatment strategies are varied for this particular pathology. It remains controversial as to what the ideal treatment strategy is. Recently, bony substitute injections have emerged as a potential option for treatment. This paper aimed to describe our institution's experience in using bony substitute injections to treat unicameral bone cysts. Methods A retrospective review of consecutive patients over an 84-month period at a tertiary paediatric hospital was performed. Information regarding patients' presentation, diagnosis, and management was recorded and summarised. Results A total of 15 patients were included in our study, with a mean follow-up of 118 weeks. 86.7% of patients demonstrated clinical resolution (absence of pain at the latest follow-up) and 80% of patients demonstrated radiographic resolution. Only one patient sustained a subtrochanteric fracture post-index operation, whilst two others demonstrated redevelopment of cystic architecture on follow-up. Conclusion This study demonstrates that bone substitute injection is potentially a minimally invasive and seemingly successful technique in the treatment of unicameral bone cysts and other simple bone lesions. Further randomised and comparative studies are required to confirm and validate our findings.
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Ding L, Wang H, Li J, Liu D, Bai J, Yuan Z, Yang J, Bian L, Zhao X, Li B, Chen S. Preparation and characterizations of an injectable and biodegradable high-strength iron-bearing brushite cement for bone repair and vertebral augmentation applications. Biomater Sci 2022; 11:96-107. [PMID: 36445030 DOI: 10.1039/d2bm01535h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Brushite cements have good osteoconductive and resorbable properties, but the low mechanical strength and poor injectability limit their clinical applications in load-bearing conditions and minimally invasive surgery. In this study, an injectable brushite cement that contains monocalcium phosphate monohydrate (MCPM) and β-tricalcium phosphate (β-TCP) as its solid phase and ammonium ferric citrate (AFC) solution as the aqueous medium was designed to have high mechanical strength. The optimized formulation achieved a compressive strength of 62.8 ± 7.2 MPa, which is above the previously reported values of hand-mixing brushite cements. The incorporation of AFC prolonged the setting times and greatly enhanced the injectability and degradation properties of the cements. In vitro and in vivo experiments demonstrated that the brushite cements exhibited good biocompatibility and bone regeneration capacity. The novel brushite cement is promising for bone healing in load-bearing applications.
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Affiliation(s)
- Luguang Ding
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Suzhou Medical College, Soochow University, Suzhou, Jiangsu 215006, China.
| | - Huan Wang
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Suzhou Medical College, Soochow University, Suzhou, Jiangsu 215006, China.
| | - Jiaying Li
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Suzhou Medical College, Soochow University, Suzhou, Jiangsu 215006, China.
| | - Dachuan Liu
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Suzhou Medical College, Soochow University, Suzhou, Jiangsu 215006, China.
| | - Jianzhong Bai
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Suzhou Medical College, Soochow University, Suzhou, Jiangsu 215006, China.
| | - Zhangqin Yuan
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Suzhou Medical College, Soochow University, Suzhou, Jiangsu 215006, China.
| | - Jiaojiao Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China
| | - Lu Bian
- Department of Orthopaedics, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 214122, China.
| | - Xijiang Zhao
- Department of Orthopaedics, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 214122, China.
| | - Bin Li
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Suzhou Medical College, Soochow University, Suzhou, Jiangsu 215006, China.
| | - Song Chen
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Suzhou Medical College, Soochow University, Suzhou, Jiangsu 215006, China.
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14
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Vezenkova A, Locs J. Sudoku of porous, injectable calcium phosphate cements – Path to osteoinductivity. Bioact Mater 2022; 17:109-124. [PMID: 35386461 PMCID: PMC8964990 DOI: 10.1016/j.bioactmat.2022.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/28/2021] [Accepted: 01/03/2022] [Indexed: 12/16/2022] Open
Abstract
With the increase of global population, people's life expectancy is growing as well. Humans tend to live more active lifestyles and, therefore, trauma generated large defects become more common. Instances of tumour resection or pathological conditions and complex orthopaedic issues occur more frequently increasing necessity for bone substitutes. Composition of calcium phosphate cements (CPCs) is comparable to the chemical structure of bone minerals. Their ability to self-set and resorb in vivo secures a variety of potential applications in bone regeneration. Despite the years-long research and several products already reaching the market, finding the right properties for calcium phosphate cement to be osteoinductive and both injectable and suitable for clinical use is still a sudoku. This article is focused on injectable, porous CPCs, reviewing the latest developments on the path toward finding osteoinductive material, which is suitable for injection. Phase separation is an essential factor to be improved to obtain injectable material; several methods have been proposed. Osteoinductive bone substitutes – possible solution for bad mechanical performance of CPCs. Osteoinductivity of CPC could be attained even without the addition of different supplements. Less complex composition of CPC – potentially reduced price of the final product and wider availability on the market.
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15
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WINGE MI, JOHANSSON CB, RØKKUM M. Biopsies from the Distal Radius after Implantation of Calcium Phosphate Cement. J Hand Surg Asian Pac Vol 2022; 27:852-863. [DOI: 10.1142/s2424835522500837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Calcium Phosphate (CaP) bone cement is gradually replaced by new bone when used as a gap-filler. Details of the re-modelling process are still unclear. Uncertainty is also present as to the possible release of cement particles during the resorption phase causing local soft tissue reactions. The objective of this study was to perform a comprehensive histological investigation of the injectable CaP bone cement used as a void filler in corrective radius osteotomies and adjacent tissue reactions. Methods: Fourteen patients, median age 56 years (18–72), 4 men/10 women, underwent removal of distal radius plates (11 dorsal/3 volar) due to tenosynovitis-like symptoms. Eleven study patients went through corrective osteotomies with CaP bone cement and three were control patients. Previous surgery in three controls consisted in (1) corrective osteotomy with bone graft (dorsal plate), and (2) plated distal radius fractures (1 dorsal/1 volar plate). Biopsies were taken of bone-cement-bone junctions (11), bone-bone graft-bone junctions (1), bone (2) and juxtaposing soft tissue (14). The interval from corrective CaP cement surgery to biopsy was median 1.1 (0.6–2.3) years. Results: Biopsies of bone-cement junctions showed the different stages of new bone formation from CaP to immature bone and later mature well-organised bone. The cement showed signs of osteoclast-mediated resorption. Cement particles, macrophages, multinucleated giant cells (MNGC) and plasma cells were observed in most soft tissue biopsies. MNGC with internalised particles were seen. Macrophages were found along and/or within tendon sheaths in all patients in both groups, but rarely containing cement particles. Conclusions: Gradual re-modelling of the cement into well-organised bone was observed confirming osteoclast–osteoblast coupling. There was no indication that cement particles were the cause of the tenosynovitis-like symptoms.
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Affiliation(s)
- Mona I. WINGE
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Carina B. JOHANSSON
- Department of Prosthodontics/Dental Materials Science, University of Gothenburg, Sahlgrenska Academy, Göteborg, Sweden
| | - Magne RØKKUM
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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16
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Kowalewicz K, Waselau AC, Feichtner F, Schmitt AM, Brückner M, Vorndran E, Meyer-Lindenberg A. Comparison of degradation behavior and osseointegration of 3D powder-printed calcium magnesium phosphate cement scaffolds with alkaline or acid post-treatment. Front Bioeng Biotechnol 2022; 10:998254. [PMID: 36246367 PMCID: PMC9554004 DOI: 10.3389/fbioe.2022.998254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Due to the positive effects of magnesium substitution on the mechanical properties and the degradation rate of the clinically well-established calcium phosphate cements (CPCs), calcium magnesium phosphate cements (CMPCs) are increasingly being researched as bone substitutes. A post-treatment alters the materials’ physical properties and chemical composition, reinforcing the structure and modifying the degradation rate. By alkaline post-treatment with diammonium hydrogen phosphate (DAHP, (NH4)2HPO4), the precipitation product struvite is formed, while post-treatment with an acidic phosphate solution [e.g., phosphoric acid (PA, H3PO4)] results in precipitation of newberyite and brushite. However, little research has yet been conducted on newberyite as a bone substitute and PA post-treatment of CMPCs has not been described in the accessible literature so far. Therefore, in the present study, the influence of an alkaline (DAHP) or acid (PA) post-treatment on the biocompatibility, degradation behavior, and osseointegration of cylindrical scaffolds (h = 5.1 mm, Ø = 4.2 mm) produced from the ceramic cement powder Ca0.75Mg2.25(PO4)2 by the advantageous manufacturing technique of three-dimensional (3D) powder printing was investigated in vivo. Scaffolds of the material groups Mg225d (DAHP post-treatment) and Mg225p (PA post-treatment) were implanted into the cancellous part of the lateral femoral condyles in rabbits. They were evaluated up to 24 weeks by regular clinical, X-ray, micro-computed tomographic (µCT), and histological examinations as well as scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX) analysis and compared with tricalcium phosphate (TCP). All materials showed excellent biocompatibility and rapid osseointegration. While TCP degraded only slightly, the CMPCs showed almost complete degradation. Mg225d demonstrated significantly faster loss of form and demarcability from surrounding bone, scaffold volume reduction, and significantly greater degradation on the side towards the bone marrow than to the cortex than Mg225p. Simultaneously, numerous bone trabeculae have grown into the implantation site. While these were mostly located on the side towards the cortex in Mg225d, they were more evenly distributed in Mg225p and showed almost the same structural characteristics as physiological bone after 24 weeks in Mg225p. Based on these results, the acid post-treated 3D powder-printed Mg225p is a promising degradable bone substitute that should be further investigated.
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Affiliation(s)
- Katharina Kowalewicz
- Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Anja-Christina Waselau
- Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Franziska Feichtner
- Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Anna-Maria Schmitt
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Würzburg, Germany
| | - Manuel Brückner
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Würzburg, Germany
| | - Elke Vorndran
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Würzburg, Germany
| | - Andrea Meyer-Lindenberg
- Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University of Munich, Munich, Germany
- *Correspondence: Andrea Meyer-Lindenberg,
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17
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Kaiser F, Schröter L, Stein S, Krüger B, Weichhold J, Stahlhut P, Ignatius A, Gbureck U. Accelerated bone regeneration through rational design of magnesium phosphate cements. Acta Biomater 2022; 145:358-371. [PMID: 35443213 DOI: 10.1016/j.actbio.2022.04.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/23/2022] [Accepted: 04/11/2022] [Indexed: 12/17/2022]
Abstract
Results of several studies during past years suggested that magnesium phosphate cements (MPCs) not only show excellent biocompatibility and osteoconductivity, but they also provide improved regeneration capacity due to higher solubility compared to calcium phosphates. These findings also highlighted that chemical similarity of bone substitutes to the natural bone tissue is not a determinant factor in the success of regenerative strategies. The aim of this study was to further improve the degradation speed of MPCs for a fast bone ingrowth within a few months. We confirmed our hypothesis, that decreasing the powder-liquid ratio (PLR) of cement results in an increased content of highly soluble phases such as struvite (MgNH4PO4⋅6H2O) as well as K-struvite (MgKPO4⋅6H2O). Promising compositions with a low PLR of 1 g ml-1 were implanted in partially-loaded tibia defects in sheep. Both cements were partially degraded and replaced by bone tissue after 4 months. The degradation speed of the K-struvite cement was significantly higher compared to the struvite cement, initially resulting in the formation of a cell-rich resorption zone at the surface of some implants, as determined by histology. Overall, both MPCs investigated in this study seem to be promising as an alternative to the clinically well-established, but slowly degrading calcium phosphate cements, depending on defect size and desired degradation rate. Whereas the K-struvite cement might require further modification towards a slower resorption and reduced inflammatory response in vivo, the struvite cement appears promising for the treatment of bone defects due to its continuous degradation with simultaneous new bone formation. STATEMENT OF SIGNIFICANCE: Cold setting bone cements are used for the treatment of bone defects that exceed a critical size and cannot heal on their own. They are applied pasty into the bone defect and harden afterwards so that the shape adapts to the individual defect. Magnesium phosphates such as magnesium ammonium phosphate hexahydrate (struvite) belong to a new class of these cold setting bone cements. They degrade much faster than the clinically established calcium phosphates. In this study, a magnesium phosphate that has hardly been investigated so far was implanted into partially-loaded defects in sheeps: Potassium magnesium phosphate hexahydrate. This showed even faster resorption compared to the struvite cement: after 4 months, 63% of the cement was already degraded.
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Affiliation(s)
- Friederike Kaiser
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany
| | - Lena Schröter
- Institute for Orthopaedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081 Ulm, Germany
| | - Svenja Stein
- Institute for Orthopaedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081 Ulm, Germany
| | - Benjamin Krüger
- Institute for Orthopaedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081 Ulm, Germany
| | - Jan Weichhold
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany
| | - Philipp Stahlhut
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany
| | - Anita Ignatius
- Institute for Orthopaedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081 Ulm, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany.
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18
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Belaid H, Barou C, Collart-Dutilleul PY, Desoutter A, Kajdan M, Bernex F, Tétreau R, Cuisinier F, Barés J, Huon V, Teyssier C, Cornu D, Cavaillès V, Bechelany M. Fabrication of Radio-Opaque and Macroporous Injectable Calcium Phosphate Cement. ACS APPLIED BIO MATERIALS 2022; 5:3075-3085. [PMID: 35584545 DOI: 10.1021/acsabm.2c00345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this work was the development of injectable radio-opaque and macroporous calcium phosphate cement (CPC) to be used as a bone substitute for the treatment of pathologic vertebral fractures. A CPC was first rendered radio-opaque by the incorporation of zirconium dioxide (ZrO2). In order to create macroporosity, poly lactic-co-glycolic acid (PLGA) microspheres around 100 μm were homogeneously incorporated into the CPC as observed by scanning electron microscopy. Physicochemical analyses by X-ray diffraction and Fourier transform infrared spectroscopy confirmed the brushite phase of the cement. The mechanical properties of the CPC/PLGA cement containing 30% PLGA (wt/wt) were characterized by a compressive strength of 2 MPa and a Young's modulus of 1 GPa. The CPC/PLGA exhibited initial and final setting times of 7 and 12 min, respectively. Although the incorporation of PLGA microspheres increased the force necessary to inject the cement and decreased the percentage of injected mass as a function of time, the CPC/PLGA appeared fully injectable at 4 min. Moreover, in comparison with CPC, CPC/PLGA showed a full degradation in 6 weeks (with 100% mass loss), and this was associated with an acidification of the medium containing the CPC/PLGA sample (pH of 3.5 after 6 weeks). A cell viability test validated CPC/PLGA biocompatibility, and in vivo analyses using a bone defect assay in the caudal vertebrae of Wistar rats showed the good opacity of the CPC through the tail and a significant increased degradation of the CPC/PLGA cement a month after implantation. In conclusion, this injectable CPC scaffold appears to be an interesting material for bone substitution.
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Affiliation(s)
- Habib Belaid
- Institut Européen des Membranes, IEM, UMR 5635, Univ Montpellier, CNRS, ENSCM, 34095 Montpellier, France.,IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, F-34298 Montpellier, France
| | - Carole Barou
- Institut Européen des Membranes, IEM, UMR 5635, Univ Montpellier, CNRS, ENSCM, 34095 Montpellier, France.,IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, F-34298 Montpellier, France.,Biologics 4 Life, 84120 Pertuis, France
| | | | - Alban Desoutter
- Laboratoire de Bioingénierie et Nanosciences, EA4203, Université de Montpellier, 34193 Montpellier, France
| | - Marilyn Kajdan
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, F-34298 Montpellier, France
| | - Florence Bernex
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, F-34298 Montpellier, France.,BioCampus, RHEM, Université de Montpellier, CNRS UAR3426, INSERM, F-34298 Montpellier, France
| | - Raphaël Tétreau
- Service d'Imagerie, Institut Régional du Cancer Montpellier, Montpellier F-34298, France
| | - Frédéric Cuisinier
- Laboratoire de Bioingénierie et Nanosciences, EA4203, Université de Montpellier, 34193 Montpellier, France
| | - Jonathan Barés
- Laboratoire de Mécanique et Génie Civil, Univ Montpellier, CNRS, Montpellier 34090, France
| | - Vincent Huon
- Laboratoire de Mécanique et Génie Civil, Univ Montpellier, CNRS, Montpellier 34090, France
| | - Catherine Teyssier
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, F-34298 Montpellier, France
| | - David Cornu
- Institut Européen des Membranes, IEM, UMR 5635, Univ Montpellier, CNRS, ENSCM, 34095 Montpellier, France
| | - Vincent Cavaillès
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, F-34298 Montpellier, France
| | - Mikhael Bechelany
- Institut Européen des Membranes, IEM, UMR 5635, Univ Montpellier, CNRS, ENSCM, 34095 Montpellier, France
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19
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Kumar TSS, Madhumathi K, Jayasree R. Eggshell Waste: A Gold Mine for Sustainable Bioceramics. J Indian Inst Sci 2022. [DOI: 10.1007/s41745-022-00291-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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20
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Tsuchiya A, Freitas PP, Nagashima N, Ishikawa K. Influence of pH and ion components in the liquid phase on the setting reaction of carbonate apatite granules. Dent Mater J 2021; 41:209-213. [PMID: 34690229 DOI: 10.4012/dmj.2021-211] [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: 11/23/2022]
Abstract
Carbonate apatite (CO3Ap) is an inorganic component of bone and replaces by natural bone after implantation into the bone defect. Because of this unique characteristic, CO3Ap granules have been used in the dental field. However, washing out of granules from the bone defect area is an issue. The aim of this study was to set CO3Ap granules by mixing CO3Ap granules with acidic phosphate solutions and evaluate the influence of the pH and ion components of the solutions. When Na+ was the counter ion, the amount of precipitated dicalcium phosphate dihydrate (DCPD) was small and the setting ability disappeared with increasing pH of the solutions. Alternatively, when the counter ion was Ca2+, the amount of precipitated DCPD was high and the setting ability was observed even at high pH. These results suggest the presence of Ca2+ in the acidic phosphate solution is a key for fabricating CO3Ap granular cement.
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Affiliation(s)
- Akira Tsuchiya
- Department of Biomaterials, Faculty of Dental Science, Kyushu University
| | | | - Nozomi Nagashima
- Department of Biomaterials, Faculty of Dental Science, Kyushu University
| | - Kunio Ishikawa
- Department of Biomaterials, Faculty of Dental Science, Kyushu University
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21
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Malmberg P, Lopes VR, Billström GH, Gallinetti S, Illies C, Linder LKB, Birgersson U. Targeted ToF-SIMS Analysis of Macrophage Content from a Human Cranial Triphasic Calcium Phosphate Implant. ACS APPLIED BIO MATERIALS 2021; 4:6791-6798. [PMID: 35006979 DOI: 10.1021/acsabm.1c00513] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Macrophages play a key role in determining the fate of implanted biomaterials, especially for biomaterials such as calcium phosphates (CaPs) where these cells play a vital role in material resorption and osteogenesis, as shown in different models, including clinical samples. Although substantial consideration is given to the design and validation of different CaPs, relatively little is known about their material-cell interaction. Specifically, the intracellular content of different CaP phases remains to be assessed, even though CaP-filled macrophages have been observed in several studies. In this study, 2D/3D ToF-SIMS imaging and multivariate analysis were directly applied on the histology samples of an explant to reveal the content of macrophages. The cellular content of the macrophages was analyzed to distinguish three CaP phases, monetite, beta-tricalcium phosphate, and pyrophosphate, which are all part of the monetite-based CaP implant composition under study. ToF-SIMS combined with histology revealed that the content of the identified macrophages was most similar to that of the pyrophosphate phase. This study is the first to uncover distinct CaP phases in macrophages from a human multiphasic CaP explant by targeted direct cell content analysis. The uncovering of pyrophosphate as the main phase found inside the macrophages is of great importance to understand the impact of the selected material in the process of biomaterial-instructed osteogenesis.
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Affiliation(s)
- Per Malmberg
- Department of Chemistry and Chemical Engineering, Chalmers University of Technology, 412 96 Gothenburg, Sweden
| | - Viviana R Lopes
- Science for Life Laboratory, Department of Medicinal Chemistry, Uppsala University, 751 83 Uppsala, Sweden
| | - Gry Hulsart Billström
- Science for Life Laboratory, Department of Medicinal Chemistry, Uppsala University, 751 83 Uppsala, Sweden
| | - Sara Gallinetti
- Department of Engineering Sciences, Applied Materials Science Section, Uppsala University, 75121 Uppsala, Sweden
| | - Christopher Illies
- Department of Clinical Pathology, Karolinska University Hospital, 171 77 Stockholm, Sweden
| | - Lars Kihlström Burenstam Linder
- Department of Clinical Neuroscience, Neurosurgical Section, Karolinska University Hospital and Karolinska Institute, 171 76 Stockholm, Sweden
| | - Ulrik Birgersson
- Department of Clinical Neuroscience, Neurosurgical Section, Karolinska University Hospital and Karolinska Institute, 171 76 Stockholm, Sweden.,Division of Imaging and Technology, Department of Clinical Science, Intervention and Technology, Karolinska Institute, 14152 Huddinge, Sweden
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22
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Fabrication of Drug-Loaded Calcium Phosphate Nanoparticles: An Investigation of Microbial Toxicity. J CLUST SCI 2021. [DOI: 10.1007/s10876-021-02104-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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23
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Zhou H, Yang L, Gbureck U, Bhaduri SB, Sikder P. Monetite, an important calcium phosphate compound-Its synthesis, properties and applications in orthopedics. Acta Biomater 2021; 127:41-55. [PMID: 33812072 DOI: 10.1016/j.actbio.2021.03.050] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 12/15/2022]
Abstract
This review recognizes a unique calcium phosphate (CaP) phase known as monetite or dicalcium phosphate anhydrous (DCPA, CaHPO4), and presents an overview of its properties, processing, and applications in orthopedics. The motivation for the present effort is to highlight the state-of-the-art research and development of monetite and propel the research community to explore more of its potentials in orthopedics. After a brief introduction of monetite, we provide a summary of its various synthesis routes like dehydration, solvent-based, energy-assisted processes and also discuss the formation of different crystal structures with respect to the synthesis conditions. Subsequently, we discuss the material's noteworthy physico-chemical properties including the crystal structure, vibrational spectra, solubility, thermal decomposition, and conversion to other phases. Of note, we focus on the biological (in vitro and in vivo) properties of monetite, given its ever-increasing popularity as a biomaterial for medical implants. Appropriately, we discuss various orthopedic applications of monetite as bone cement, implant coatings, granules for defect fillers, and scaffolds. Many in vitro and in vivo studies confirmed the favorable osteointegration and osteoconduction properties of monetite products, along with a better balance between implant resorption and new bone formation as compared to other CaP phases. The review ends with translational aspects of monetite and presents thoughts about its possible future research directions. Further research may explore but not limited to improvements in mechanical strength of monetite-based scaffolds, using monetite particles as a therapeutic agent delivery, and tissue engineering strategies where monetite serves as the biomaterial. STATEMENT OF SIGNIFICANCE: This is the first review that focusses on the favorable potential of monetite for hard tissue repair and regeneration. The article accurately covers the "Synthesis-Structure-Property-Applications" correlations elaborating on monetite's diverse material properties. Special focus is put on the in vitro and in vivo properties of the material highlighting monetite as an orthopedic material-of-choice. The synthesis techniques are discussed which provide important information about the different fabrication routes for monetite. Most importantly, the review provides comprehensive knowledge about the diverse biomedical applications of monetite as granules, defect--specific scaffolds, bone cements and implant coatings. This review will help to highlight monetite's potential as an effective regenerative medicine and catalyze the continuing translation of this bioceramic from the laboratory to clinics.
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Affiliation(s)
- H Zhou
- Center for Health Science and Engineering, School of Materials Science and Engineering, Hebei University of Technology, Tianjin, China; International Research Center for Translational Orthopaedics (IRCTO), Jiangsu, China
| | - L Yang
- Center for Health Science and Engineering, School of Materials Science and Engineering, Hebei University of Technology, Tianjin, China; International Research Center for Translational Orthopaedics (IRCTO), Jiangsu, China
| | - U Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital of Würzburg, Würzburg, Germany
| | - S B Bhaduri
- Department of Mechanical, Industrial & Manufacturing Engineering, The University of Toledo, Toledo, OH, USA; ENG-EEC Division, The National Science Foundation (NSF), Alexandria, VA, USA
| | - P Sikder
- Department of Mechanical Engineering, Cleveland State University, Cleveland, OH, USA.
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24
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Xi W, Ding Z, Ren H, Chen H, Yan Y, Zhang Q. Effects of pullulan on the biomechanical and anti-collapse properties of dicalcium phosphate dihydrate bone cement. J Biomater Appl 2021; 36:757-771. [PMID: 34074159 DOI: 10.1177/08853282211020158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this work, a modified dicalcium phosphate dihydrate (DCPD) bone cement with unique biodegradable ability in a calcium phosphate cement system was prepared by the hydration reaction of monocalcium phosphate monohydrate and calcium oxide and integration with pullulan (Pul), a non-toxic, biocompatible, viscous, and water-soluble polysaccharide that has been successfully used to improve defects in DCPD bone cement, especially its rapid solidification, fragile mechanical properties, and easy collapse. The effect of different contents of Pul on the structure and properties of DCPD were also studied in detail. The modified cement was characterised by X-ray diffraction, Fourier-transform infrared spectroscopy, scanning electron microscopy, ultraviolet-visible absorption, X-ray photoelectron spectroscopy analysis, and rheological property measurements. The results indicated that Pul promoted the hydration formation of DCPD, and interface bonding occurred between Pul and DCPD. With increasing content of Pul, the setting time of the DCPD bone cement increased from 2.6 min to 42.3 min, the compressive strength increased from 0 MPa to 20.4 MPa, and the anti-collapse ability also improved owing to the strong interface bonding, implying that the DCPD bone cement improved by Pul has better potential for application in the field of non-loading bone regenerative medicine compared to unmodified DCPD bone cement.
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Affiliation(s)
- Wenjing Xi
- College of Physics, Sichuan University, Chengdu, China
| | - Zhengwen Ding
- College of Physics, Sichuan University, Chengdu, China
| | - Haohao Ren
- College of Physics, Sichuan University, Chengdu, China
| | - Hong Chen
- College of Physics, Sichuan University, Chengdu, China
| | - Yonggang Yan
- College of Physics, Sichuan University, Chengdu, China
| | - Qiyi Zhang
- School of Chemical Engineering, Sichuan University, Chengdu, China
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Barker AJ, Arthur A, DeNichilo MO, Panagopoulos R, Gronthos S, Anderson PJ, Zannettino AC, Evdokiou A, Panagopoulos V. Plant-derived soybean peroxidase stimulates osteoblast collagen biosynthesis, matrix mineralization, and accelerates bone regeneration in a sheep model. Bone Rep 2021; 14:101096. [PMID: 34136591 PMCID: PMC8178086 DOI: 10.1016/j.bonr.2021.101096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/29/2021] [Accepted: 05/21/2021] [Indexed: 02/08/2023] Open
Abstract
Bone defects arising from fractures or disease represent a significant problem for surgeons to manage and are a substantial economic burden on the healthcare economy. Recent advances in the development of biomaterial substitutes provides an attractive alternative to the current "gold standard" autologous bone grafting. Despite on-going research, we are yet to identify cost effective biocompatible, osteo-inductive factors that stimulate controlled, accelerated bone regeneration.We have recently reported that enzymes with peroxidase activity possess previously unrecognised roles in extracellular matrix biosynthesis, angiogenesis and osteoclastogenesis, which are essential processes in bone remodelling and repair. Here, we report for the first time, that plant-derived soybean peroxidase (SBP) possesses pro-osteogenic ability by promoting collagen I biosynthesis and matrix mineralization of human osteoblasts in vitro. Mechanistically, SBP regulates osteogenic genes responsible for inflammation, extracellular matrix remodelling and ossification, which are necessary for normal bone healing. Furthermore, SBP was shown to have osteo-inductive properties, that when combined with commercially available biphasic calcium phosphate (BCP) granules can accelerate bone repair in a critical size long bone defect ovine model. Micro-CT analysis showed that SBP when combined with commercially available biphasic calcium phosphate (BCP) granules significantly increased bone formation within the defects as early as 4 weeks compared to BCP alone. Histomorphometric assessment demonstrated accelerated bone formation prominent at the defect margins and surrounding individual BCP granules, with evidence of intramembranous ossification. These results highlight the capacity of SBP to be an effective regulator of osteoblastic function and may be beneficial as a new and cost effective osteo-inductive agent to accelerate repair of large bone defects.
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Affiliation(s)
- Alexandra J. Barker
- Musculoskeletal Biology Research Laboratory, Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Agnes Arthur
- Mesenchymal Stem Cell Laboratory, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Mark O. DeNichilo
- Centre for Cancer Biology, University of South Australia, Adelaide, Australia
| | - Romana Panagopoulos
- Breast Cancer Research Unit, School of Medicine, Discipline of Surgery and Orthopaedics, Basil Hetzel Institute, University of Adelaide, Adelaide, Australia
| | - Stan Gronthos
- Mesenchymal Stem Cell Laboratory, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Peter J. Anderson
- Mesenchymal Stem Cell Laboratory, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
- Centre for Cancer Biology, University of South Australia, Adelaide, Australia
- Australian Craniofacial Unit, Women's and Children's Hospital, Department of Paediatrics and Dentistry, University of Adelaide, Adelaide, Australia
- Central Adelaide Local Health Network, Adelaide, Australia
| | - Andrew C.W. Zannettino
- Myeloma Research Laboratory, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
- Department of Haematology, Royal Adelaide Hospital, Adelaide, Australia
- Central Adelaide Local Health Network, Adelaide, Australia
| | - Andreas Evdokiou
- Breast Cancer Research Unit, School of Medicine, Discipline of Surgery and Orthopaedics, Basil Hetzel Institute, University of Adelaide, Adelaide, Australia
| | - Vasilios Panagopoulos
- Myeloma Research Laboratory, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
- Breast Cancer Research Unit, School of Medicine, Discipline of Surgery and Orthopaedics, Basil Hetzel Institute, University of Adelaide, Adelaide, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
- Corresponding author at: Myeloma Research Laboratory, Level 5 South, South Australian Health and Medical Research Institute, Adelaide SA 500, Australia.
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Multi-walled carbon nanotube/hydroxyapatite nanocomposite with leukocyte- and platelet-rich fibrin for bone regeneration in sheep model. Oral Maxillofac Surg 2021; 26:63-72. [PMID: 33852090 DOI: 10.1007/s10006-020-00933-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 12/10/2020] [Indexed: 10/21/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the effects of multi-walled carbon nanotubes/hydroxyapatite (MWCNT/HA) granules with or without leukocyte- and platelet-rich fibrin (L-PRF) on bone regeneration in cancellous bone of sheep model. METHODS Totally, 32 cylindrical holes were drilled in female sheep (n = 4) in the distal epiphysis and proximal metaphysis of right and left humerus and femur. The defects were randomly filled with (1) MWCNT/HA, (2) MWCNT/HA mixed with L-PRF, (3) L-PRF, and (4) left empty as control. After 8 weeks, defects were evaluated and compared radiographically using multi-slice computed tomographic (CT) scan and cone beam CT scans, histologically and histomorphometrically. RESULTS The results showed that there was no significant inflammation (> 10%) or foreign body reaction around the granules. The new lamellar bone was regenerated around the MWCNT/HA nanocomposite granules. Addition of L-PRF to MWCNT/HA demonstrated significantly improvement of new bone formation, about 27.40 ± 1.08%, in comparison with the L-PRF alone, about (12.16 ± 1.46%) (P < 0.01). Also, the rate of new bone formation was significantly greater with the use of MWCNT/HA granules (24.59 ± 1.54%) compared to the control (10.36 ± 1.17%) (P < 0.01). CONCLUSION Consequently, both biocompatibility and osteoconductivity of MWCNT/HA nanocomposite were demonstrated in the preclinical sheep model, and the use of L-PRF in combination with MWCNT/HA nanocomposite can improve bone regeneration.
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Experimental Drillable Magnesium Phosphate Cement Is a Promising Alternative to Conventional Bone Cements. MATERIALS 2021; 14:ma14081925. [PMID: 33921373 PMCID: PMC8069694 DOI: 10.3390/ma14081925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022]
Abstract
Clinically used mineral bone cements lack high strength values, absorbability and drillability. Therefore, magnesium phosphate cements have recently received increasing attention as they unify a high mechanical performance with presumed degradation in vivo. To obtain a drillable cement formulation, farringtonite (Mg3(PO4)2) and magnesium oxide (MgO) were modified with the setting retardant phytic acid (C6H18O24P6). In a pre-testing series, 13 different compositions of magnesium phosphate cements were analyzed concentrating on the clinical demands for application. Of these 13 composites, two cement formulations with different phytic acid content (22.5 wt% and 25 wt%) were identified to meet clinical demands. Both formulations were evaluated in terms of setting time, injectability, compressive strength, screw pullout tests and biomechanical tests in a clinically relevant fracture model. The cements were used as bone filler of a metaphyseal bone defect alone, and in combination with screws drilled through the cement. Both formulations achieved a setting time of 5 min 30 s and an injectability of 100%. Compressive strength was shown to be ~12–13 MPa and the overall displacement of the reduced fracture was <2 mm with and without screws. Maximum load until reduced fracture failure was ~2600 N for the cements only and ~3800 N for the combination with screws. Two new compositions of magnesium phosphate cements revealed high strength in clinically relevant biomechanical test set-ups and add clinically desired characteristics to its strength such as injectability and drillability.
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Sutthavas P, Habibovic P, van Rijt SH. The shape-effect of calcium phosphate nanoparticle based films on their osteogenic properties. Biomater Sci 2021; 9:1754-1766. [PMID: 33433541 DOI: 10.1039/d0bm01494j] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Calcium phosphates (CaPs) in the form of hydroxyapatite (HA) have been extensively studied in the context of bone regeneration due to their chemical similarity to natural bone mineral. While HA is known to promote osteogenic differentiation, the structural properties of the ceramic have been shown to affect the extent of this effect; several studies have suggested that nanostructured HA can improve the bioactivity. However, the role shape plays in the osteogenic potential is more elusive. Here we studied the effect of HA nanoparticle shape on the ability to induce osteogenesis in human mesenchymal stromal cells (hMSCs) by developing nanoparticle films using needle-, rice- and spherical-shaped HA. We showed that the HA films made from all three shapes of nanoparticles induced increased levels of osteogenic markers (i.e. runt-related transcription factor 2 (RUNX2), bone morphogenetic protein 2 (BMP2), alkaline phosphatase (ALP), osteopontin (OPN), osteocalcin (OCN) on protein and gene level in comparison to hMSCs cultured on cover glass slides. Furthermore, their expression levels and profiles differed significantly as a function of nanoparticle shape. We also showed that nanoparticle films were more efficient in inducing osteogenic gene expression in hMSCs compared to adding nanoparticles to hMSCs in culture media. Finally, we demonstrated that hMSC morphology upon adhesion to the HA nanoparticle films is dependent on nanoparticle shape, with hMSCs exhibiting a more spread morphology on needle-shaped nanoparticle films compared to hMSCs seeded on rice- and spherical-shaped nanoparticle films. Our data suggests that HA nanoparticle films are efficient in inducing hMSC osteogenesis in basic cell culture conditions and that nanoparticle shape plays a vital role in cell adhesion and morphology and extent of induction of osteogenic differentiation.
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Affiliation(s)
- Pichaporn Sutthavas
- Department of Instructive Biomaterials Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Pamela Habibovic
- Department of Instructive Biomaterials Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Sabine H van Rijt
- Department of Instructive Biomaterials Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
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In-Vivo Degradation Behavior and Osseointegration of 3D Powder-Printed Calcium Magnesium Phosphate Cement Scaffolds. MATERIALS 2021; 14:ma14040946. [PMID: 33671265 PMCID: PMC7923127 DOI: 10.3390/ma14040946] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/08/2021] [Accepted: 02/10/2021] [Indexed: 02/07/2023]
Abstract
Calcium magnesium phosphate cements (CMPCs) are promising bone substitutes and experience great interest in research. Therefore, in-vivo degradation behavior, osseointegration and biocompatibility of three-dimensional (3D) powder-printed CMPC scaffolds were investigated in the present study. The materials Mg225 (Ca0.75Mg2.25(PO4)2) and Mg225d (Mg225 treated with diammonium hydrogen phosphate (DAHP)) were implanted as cylindrical scaffolds (h = 5 mm, Ø = 3.8 mm) in both lateral femoral condyles in rabbits and compared with tricalcium phosphate (TCP). Treatment with DAHP results in the precipitation of struvite, thus reducing pore size and overall porosity and increasing pressure stability. Over 6 weeks, the scaffolds were evaluated clinically, radiologically, with Micro-Computed Tomography (µCT) and histological examinations. All scaffolds showed excellent biocompatibility. X-ray and in-vivo µCT examinations showed a volume decrease and increasing osseointegration over time. Structure loss and volume decrease were most evident in Mg225. Histologically, all scaffolds degraded centripetally and were completely traversed by new bone, in which the remaining scaffold material was embedded. While after 6 weeks, Mg225d and TCP were still visible as a network, only individual particles of Mg225 were present. Based on these results, Mg225 and Mg225d appear to be promising bone substitutes for various loading situations that should be investigated further.
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Lodoso-Torrecilla I, van den Beucken J, Jansen J. Calcium phosphate cements: Optimization toward biodegradability. Acta Biomater 2021; 119:1-12. [PMID: 33065287 DOI: 10.1016/j.actbio.2020.10.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/31/2020] [Accepted: 10/09/2020] [Indexed: 12/18/2022]
Abstract
Synthetic calcium phosphate (CaP) ceramics represent the most widely used biomaterials for bone regenerative treatments due to their biological performance that is characterized by bioactivity and osteoconductive properties. From a clinical perspective, injectable CaP cements (CPCs) are highly appealing, as CPCs can be applied using minimally invasive surgery and can be molded to optimally fill irregular bone defects. Such CPCs are prepared from a powder and a liquid component, which upon mixing form a paste that can be injected into a bone defect and hardens in situ within an appropriate clinical time window. However, a major drawback of CPCs is their poor degradability. Ideally, CPCs should degrade at a suitable pace to allow for concomitant new bone to form. To overcome this shortcoming, control over CPC degradation has been explored using multiple approaches that introduce macroporosity within CPCs. This strategy enables faster degradation of CPC by increasing the surface area available to interact with the biological surroundings, leading to accelerated new bone formation. For a comprehensive overview of the path to degradable CPCs, this review presents the experimental procedures followed for their development with specific emphasis on (bio)material properties and biological performance in pre-clinical bone defect models.
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Schröter L, Kaiser F, Stein S, Gbureck U, Ignatius A. Biological and mechanical performance and degradation characteristics of calcium phosphate cements in large animals and humans. Acta Biomater 2020; 117:1-20. [PMID: 32979583 DOI: 10.1016/j.actbio.2020.09.031] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/21/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022]
Abstract
Calcium phosphate cements (CPCs) have been used to treat bone defects and support bone regeneration because of their good biocompatibility and osteointegrative behavior. Since their introduction in the 1980s, remarkable clinical success has been achieved with these biomaterials, because they offer the unique feature of being moldable and even injectable into implant sites, where they harden through a low-temperature setting reaction. However, despite decades of research efforts, two major limitations concerning their biological and mechanical performance hamper a broader clinical use. Firstly, achieving a degradation rate that is well adjusted to the dynamics of bone formation remains a challenging issue. While apatite-forming CPCs frequently remain for years at the implant site without major signs of degradation, brushite-forming CPCs are considered to degrade to a greater extent. However, the latter tend to convert into lower soluble phases under physiological conditions, which makes their degradation behavior rather unpredictable. Secondly, CPCs exhibit insufficient mechanical properties for load bearing applications because of their inherent brittleness. This review places an emphasis on these limitations and provides an overview of studies that have investigated the biological and biomechanical performance as well as the degradation characteristics of different CPCs after implantation into trabecular bone. We reviewed studies performed in large animals, because they mimic human bone physiology more closely in terms of bone metabolism and mechanical loading conditions compared with small laboratory animals. We compared the results of these studies with clinical trials that have dealt with the degradation behavior of CPCs after vertebroplasty and kyphoplasty.
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Affiliation(s)
- Lena Schröter
- Institute for Orthopedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstrasse 14, D-89081 Ulm, Germany
| | - Friederike Kaiser
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany
| | - Svenja Stein
- Institute for Orthopedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstrasse 14, D-89081 Ulm, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany.
| | - Anita Ignatius
- Institute for Orthopedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstrasse 14, D-89081 Ulm, Germany
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Li X, Li G, Zhang K, Pei Z, Zhao S, Li J. Cu-loaded Brushite bone cements with good antibacterial activity and operability. J Biomed Mater Res B Appl Biomater 2020; 109:877-889. [PMID: 33112029 DOI: 10.1002/jbm.b.34752] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 09/28/2020] [Accepted: 10/17/2020] [Indexed: 01/29/2023]
Abstract
Bone defect-related surgical procedures are traumatic processes carrying potential inflammation and infection risks in the clinic, which are associated with prolonged antibiotic therapy that promotes bacterial antibiotic-resistance. In the present study, Cu-loaded brushite bone cements were designed, and the properties of the bone cements were evaluated. The setting time of the cement was prolonged from 12 to 50 min as the copper content increased. All cements were anti-washout, and the injectable coefficient of the cements was approximately 88%. Scanning electron microscopy results revealed that the crystal grains grew larger and thicker as the copper content in the cement increased, and brushite was determined to be the dominant crystalline phase for all the cements. However, a small amount of newly formed calcium copper phosphate was observed in the cement. Simultaneously, band shifts were observed in the Fourier transform infrared spectroscopy results at a Cu content of 5%. Moreover, the addition of Cu improved the compressive strength of brushite cements, and all cements were degradable. Furthermore, the Cu-loaded brushite bone cements performed well in inhibiting the growth and proliferation of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa, and the diameter of the inhibition zone increased with increasing copper content. The study revealed that the Cu-loaded brushite bone cements possessed good cellular affinity to mouse bone marrow stem cells when a lower dose of copper was added in vitro. These results support the great potential of injectable antibacterial brushite bone cement specifically for bone tissue defect-related repair and regeneration.
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Affiliation(s)
- Xiaoyu Li
- Central laboratory, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- College of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, Henan, China
| | - Guangda Li
- College of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, Henan, China
| | - Kaili Zhang
- College of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, Henan, China
| | - Zhengjun Pei
- College of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, Henan, China
| | - Santuan Zhao
- College of Material Science and Engineering, Henan University of Science and Technology, Luoyang, Henan, China
| | - Jinghua Li
- College of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, Henan, China
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Kruppke B, Heinemann C, Gebert A, Rohnke M, Weiß M, Henß A, Wiesmann HP, Hanke T. Strontium substitution of gelatin modified calcium hydrogen phosphates as porous hard tissue substitutes. J Biomed Mater Res A 2020; 109:722-732. [PMID: 32654374 DOI: 10.1002/jbm.a.37057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 12/27/2022]
Abstract
Aiming at the generation of a high strontium-containing degradable bone substitute, the exchange of calcium with strontium in gelatin-modified brushite was investigated. The ion substitution showed two mineral groups, the high-calcium containing minerals with a maximum measured molar Ca/Sr ratio of 80%/20% (mass ratio 63%/37%) and the high-strontium containing ones with a maximum measured molar Ca/Sr ratio of 21%/79% (mass ratio 10%/90%). In contrast to the high-strontium mineral phases, a high mass loss was observed for the calcium-based minerals during incubation in cell culture medium (alpha-MEM), but also an increase in strength owing to dissolution and re-precipitation. This resulted for the former in a decrease of cation concentration (Ca + Sr) in the medium, while the pH value decreased and the phosphate ion concentration rose significantly. The latter group of materials, the high-strontium containing ones, showed only a moderate change in mass and a decrease in strength, but the Ca + Sr concentration remained permanently above the initial calcium concentration in the medium. This might be advantageous for a future planned application by supporting bone regeneration on the cellular level.
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Affiliation(s)
- Benjamin Kruppke
- Institute of Materials Science, Max Bergmann Center of Biomaterials, Technische Universität Dresden, Dresden, Germany
| | - Christiane Heinemann
- Institute of Materials Science, Max Bergmann Center of Biomaterials, Technische Universität Dresden, Dresden, Germany
| | - Annett Gebert
- Institute for Complex Materials, Leibniz-Institute for Solid State and Materials Research Dresden (IFW Dresden), Dresden, Germany
| | - Marcus Rohnke
- Institute of Physical Chemistry, Justus-Liebig-Universität Gießen, Gießen, Germany
| | - Manuel Weiß
- Institute of Physical Chemistry, Justus-Liebig-Universität Gießen, Gießen, Germany
| | - Anja Henß
- Institute of Physical Chemistry, Justus-Liebig-Universität Gießen, Gießen, Germany
| | - Hans-Peter Wiesmann
- Institute of Materials Science, Max Bergmann Center of Biomaterials, Technische Universität Dresden, Dresden, Germany
| | - Thomas Hanke
- Institute of Materials Science, Max Bergmann Center of Biomaterials, Technische Universität Dresden, Dresden, Germany
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Hybrid Bone Scaffold Induces Bone Bridging in Goat Calvarial Critical Size Defects Without Growth Factor Augmentation. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2020. [DOI: 10.1007/s40883-019-00144-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Abstract
In the present study, a series of four different scaffolds were comparatively evaluated in a goat calvarial critical size defect model. Such studies are only rarely reported in the literature. In our work, E1001(1k), a member of a large combinational library of tyrosine-derived polycarbonates (TyrPC), was used to prepare two calcium phosphate hybrid, biodegradable bone scaffolds. In one formulation, the widely used β-tricalcium phosphate (β-TCP) was incorporated into the polymer scaffold. In the second formulation, a coating of dicalcium phosphate dihydrate (DCPD, also known as brushite) was used as the mineral phase. These scaffolds were evaluated for bone regeneration in goat calvarial 20-mm critical size defects (CSD) after 16 weeks. Results were compared with chronOS (a clinically used product) and E1001(1k)/β-TCP scaffolds, augmented with 400 μg of recombinant human bone morphogenetic protein-2 (rhBMP-2). Microcomputed tomography (micro-CT) and histomorphometry were used to assess bone regeneration within the defects. Histomorphometry showed that rhBMP-2-augmented E1001(1k)/β-TCP scaffolds completely healed the defect in all animals within 16 weeks. Among the hybrid scaffolds that were not augmented with rhBMP-2, the degree of bone regeneration within the defect area was low for the clinically used chronOS, which is a poly(lactide co-ε-caprolactone)/β-TCP hybrid scaffold. Similar results were obtained for E1001(1k)/β-TCP scaffolds, indicating that replacing poly(lactide co-ε-caprolactone) with E1001(1k) does not improve bone regeneration is this model. However, a statistically significant improvement of bone regeneration was observed for E1001(1k)/DCPD scaffolds. These scaffolds resulted in significant levels of bone regeneration in all animals and in complete bridging of the defect in three of six tests. This is the first report of a synthetic bone scaffold being able to heal a critical size calvarial defect in a large animal model without the addition of exogenous growth factors.
Lay Summary
Reconstruction of large bone defects is a significant clinical problem. The overwhelming majority of all research results are obtained in vitro or in small animal models (mouse, rat, rabbit) that cannot predict the clinical outcomes in humans. We address this problem by conducting our studies in a goat calvarial critical size defect model, which is widely regarded as predictive of human outcomes. Among the three rhBMP-2-free scaffolds tested, only one specific formulation, E1001(1k)/DCPD, resulted in massive bone ingrowth into the center of the defect in all animals and in complete bridging of the defect 50% of the animals. This is the first time, a synthetic bone scaffold was able to heal a critical size calvarial defect in a large animal model without the addition of biological growth factors. Given the high cost of biologically enhanced bone grafts and the regulatory complexities of their FDA market clearance, the development of E1001(1k)/DCPD hybrid scaffolds addresses a significant clinical need.
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Padilla S, Benito-Garzón L, Enciso Sanz S, Garzón-Gutiérrez A, García Carrodeguas R, Rodríguez MA, Garcia de Castro A, Canillas M. Novel Osteoinductive and Osteogenic Scaffolds of Monetite, Amorphous Calcium Phosphate, Hydroxyapatite, and Silica Gel: Influence of the Hydroxyapatite/Monetite Ratio on Their In Vivo Behavior and on Their Physical and Chemical Properties. ACS Biomater Sci Eng 2020; 6:3440-3453. [DOI: 10.1021/acsbiomaterials.9b01689] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sussette Padilla
- Departamento de Química en Ciencias Farmacéuticas, Facultad Farmacia, Universidad Complutense, Madrid 28040, Spain
- AzureBio SL, Tres Cantos, Madrid 28760, Spain
| | - Lorena Benito-Garzón
- Departamento de Cirugía, Facultad de Medicina, Universidad de Salamanca, Salamanca 37008, Spain
| | | | | | | | | | | | - María Canillas
- Instituto de Cerámica y Vidrio, CSIC, Cantoblanco, Madrid 28049, Spain
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Yalman V, Çelik E, Arslan Ö, Alkan F, Türkoğlu NL, Şirin HT, Arslan AK, Demirbilek M. A study on bone tissue engineering: Injectable chitosan-g-stearic acid putty. Technol Health Care 2020; 28:227-239. [PMID: 32200363 DOI: 10.3233/thc-191775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Bioengineering products can help bone tissue regeneration. OBJECTIVE There is an ongoing research for more effective biomaterials in bone regeneration. Chitosan (Ch) grafted stearic acid (Ch-g-Sa) polymer was synthesized and its usability as a putty was evaluated in this study. METHODS The chemical structure of Ch-g-Sa polymer was investigated using Proton nuclear magnetic resonance (H-NMR) and Fourier-transformed infrared spectroscopy-attenuated total reflectance (FTIR-ATR). Thermal properties of Ch-g-Sa polymer were determined by thermal gravimetric analysis (TGA). Putties containing nano-hydroxyapatite were prepared and in-vitro degradation properties and viscosity of the putties were determined. RESULTS The cytotoxicity, oxidation effect and osteogenic potential of the putties were investigated on MC3T3 cells while the inflammatory effect of the putties was studied on THP-1 cells. For the determination of the osteogenic effect of the putties, ALP and RUNX2 gene expression of MC3T3 cells were studied. CONCLUSION Ch-g-Sa/HA putties are promising biomaterials for bone tissue regeneration.
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Affiliation(s)
- Volkan Yalman
- Department of Molecular Biology and Genetics, Yıldız Technical University, Istanbul, 34349, Turkey
| | - Ekin Çelik
- Medical Biology Department, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, 40100, Turkey
| | - Ömer Arslan
- Advanced Technologies Research and Application Center, Hacettepe University, Ankara, 06800, Turkey
| | - Funda Alkan
- Department of Chemistry, Polatlı Faculty of Arts and Sciences, Ankara Hacı Bayram Veli University, Ankara, 06900, Turkey
| | - Nelisa Laçin Türkoğlu
- Department of Molecular Biology and Genetics, Yıldız Technical University, Istanbul, 34349, Turkey
| | - Hasret Tolga Şirin
- Department of Chemistry, Polatlı Faculty of Arts and Sciences, Ankara Hacı Bayram Veli University, Ankara, 06900, Turkey
| | - Arslan Kağan Arslan
- Department of Orthopedics and Traumatology, Yenimahalle Training and Research Hospital, Ankara, 06800, Turkey
| | - Murat Demirbilek
- Advanced Technologies Research and Application Center, Hacettepe University, Ankara, 06800, Turkey
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Neutralized Dicalcium Phosphate and Hydroxyapatite Biphasic Bioceramics Promote Bone Regeneration in Critical Peri-Implant Bone Defects. MATERIALS 2020; 13:ma13040823. [PMID: 32054126 PMCID: PMC7079663 DOI: 10.3390/ma13040823] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/10/2020] [Accepted: 02/10/2020] [Indexed: 12/17/2022]
Abstract
The aim of this study was to evaluate the efficacy of bone regeneration in developed bioceramics composed of dicalcium phosphate and hydroxyapatite (DCP/HA). Critical bony defects were prepared in mandibles of beagles. Defects were grafted using DCP/HA or collagen-enhanced particulate biphasic calcium phosphate (TCP/HA/Col), in addition to a control group without grafting. To assess the efficacy of new bone formation, implant stability quotient (ISQ) values, serial bone labeling, and radiographic and histological percentage of marginal bone coverage (PMBC) were carefully evaluated four, eight, and 12 weeks after surgery. Statistically significant differences among the groups were observed in the histological PMBC after four weeks. The DCP/HA group consistently exhibited significantly higher ISQ values and radiographic and histological PMCB eight and 12 weeks after surgery. At 12 weeks, the histological PMBC of DCP/HA (72.25% ± 2.99%) was higher than that in the TCP/HA/Col (62.61% ± 1.52%) and control groups (30.64% ± 2.57%). After rigorously evaluating the healing of biphasic DCP/HA bioceramics with a critical size peri-implant model with serial bone labeling, we confirmed that neutralized bioceramics exhibiting optimal compression strength and biphasic properties show promising efficacy in fast bone formation and high marginal bone coverage in peri-implant bone defects.
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Vlad MD, Fernández Aguado E, Gómez González S, Ivanov IC, Şindilar EV, Poeată I, Iencean AŞ, Butnaru M, Avădănei ER, López López J. Novel titanium-apatite hybrid scaffolds with spongy bone-like micro architecture intended for spinal application: In vitro and in vivo study. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 110:110658. [PMID: 32204086 DOI: 10.1016/j.msec.2020.110658] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/05/2020] [Accepted: 01/08/2020] [Indexed: 12/20/2022]
Abstract
Titanium alloy scaffolds with novel interconnected and non-periodic porous bone-like micro architecture were 3D-printed and filled with hydroxyapatite bioactive matrix. These novel metallic-ceramic hybrid scaffolds were tested in vitro by direct-contact osteoblast cell cultures for cell adhesion, proliferation, morphology and gene expression of several key osteogenic markers. The scaffolds were also evaluated in vivo by implanting them on transverse and spinous processes of sheep's vertebras and subsequent histology study. The in vitro results showed that: (a) cell adhesion, proliferation and viability were not negatively affected with time by compositional factors (quantitative MTT-assay); (b) the osteoblastic cells were able to adhere and to attain normal morphology (fluorescence microscopy); (c) the studied samples had the ability to promote and sustain the osteogenic differentiation, matrix maturation and mineralization in vitro (real-time quantitative PCR and mineralized matrix production staining). Additionally, the in vivo results showed that the hybrid scaffolds had greater infiltration, with fully mineralized bone after 6 months, than the titanium scaffolds without bioactive matrix. In conclusion, these novel hybrid scaffolds could be an alternative to the actual spinal fusion devices, due to their proved osteogenic performance (i.e. osteoinductive and osteoconductive behaviour), if further dimensional and biomechanical optimization is performed.
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Affiliation(s)
- Maria Daniela Vlad
- Faculty of Medical Bioengineering, "Grigore T. Popa" University of Medicine and Pharmacy from Iasi, Str. Kogălniceanu 9-13, 700454 Iasi, Romania; TRANSCEND Research Centre, Regional Institute of Oncology, Str. G-ral Henri Mathias Berthelot 2-4, 700483 Iași, Romania.
| | - Enrique Fernández Aguado
- Research Group of Interacting Surfaces in Bioengineering and Materials Science (InSup), Technical University of Catalonia (UPC), Avda. Diagonal 647, 08028 Barcelona, Spain
| | - Sergio Gómez González
- Research Group of Interacting Surfaces in Bioengineering and Materials Science (InSup), Technical University of Catalonia (UPC), Avda. Diagonal 647, 08028 Barcelona, Spain
| | - Iuliu Cristian Ivanov
- TRANSCEND Research Centre, Regional Institute of Oncology, Str. G-ral Henri Mathias Berthelot 2-4, 700483 Iași, Romania
| | - Eusebiu Viorel Şindilar
- Faculty of Veterinary Medicine, University "Ion Ionescu de la Brad" of Agricultural Sciences and Veterinary Medicine, Str. Aleea M. Sadoveanu, no. 8, 700489 Iasi, Romania
| | - Ion Poeată
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy from Iasi, Str. Universității no. 16, 700115 Iasi, Romania
| | - Andrei Ştefan Iencean
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy from Iasi, Str. Universității no. 16, 700115 Iasi, Romania
| | - Maria Butnaru
- Faculty of Medical Bioengineering, "Grigore T. Popa" University of Medicine and Pharmacy from Iasi, Str. Kogălniceanu 9-13, 700454 Iasi, Romania
| | - Elena Roxana Avădănei
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy from Iasi, Str. Universității no. 16, 700115 Iasi, Romania
| | - José López López
- Research Group of Interacting Surfaces in Bioengineering and Materials Science (InSup), Technical University of Catalonia (UPC), Avda. Diagonal 647, 08028 Barcelona, Spain
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Jayasree R, Kumar TSS, Venkateswari R, Nankar RP, Doble M. Eggshell derived brushite bone cement with minimal inflammatory response and higher osteoconductive potential. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:113. [PMID: 31583477 DOI: 10.1007/s10856-019-6315-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/21/2019] [Indexed: 06/10/2023]
Abstract
Brushite cements are known for excellent osteoconductive and degradation properties, however, its widespread use is limited due to rapid setting time and poor mechanical properties. The eggshell derived calcium phosphates exhibits improved physical and biological properties due to the presence of biologically relevant ions. In this study, eggshell derived brushite cement (EB) was fabricated using β-tricalcium phosphate synthesized from eggshells. The presence of trace elements in EB prolonged its setting time. The size of brushite crystals in EB was found to be smaller than the pure brushite cement (PB) leading to increased initial compressive strength and higher in vitro degradation rate. The L6 and MG63 cell lines exhibited good biocompatibility with the cement at the end 72 h. In vivo studies of the cements were performed in rat calvarial defect model. Micro CT analysis showed faster degradation and accelerated bone formation in EB filled defect. Histological studies revealed infiltration of inflammatory cells into the implant site for both the cements till 6th week. However, inflammation was found to be significantly reduced at the 12th week in EB compared to PB leading to complete bone bridge formation. Multi-ion substituted EB seems to be a potential bone substitute material with a reasonable setting time for ease of handling, higher mechanical strength, minimal inflammatory response and higher bone regeneration.
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Affiliation(s)
- R Jayasree
- Medical Materials Laboratory, Department of Metallurgical and Materials Engineering, Indian Institute of Technology Madras, Chennai, 600036, India
| | - T S Sampath Kumar
- Medical Materials Laboratory, Department of Metallurgical and Materials Engineering, Indian Institute of Technology Madras, Chennai, 600036, India.
| | - R Venkateswari
- Department of Medical Biochemistry, Dr. ALM Mudaliar Postgraduate Institute of Basic Medical Sciences, University of Madras, Chennai, 600042, India
| | - Rakesh P Nankar
- Department of Biotechnology, Indian Institute of Technology Madras, Chennai, 600036, India
| | - Mukesh Doble
- Department of Biotechnology, Indian Institute of Technology Madras, Chennai, 600036, India
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Hasan ML, Kim B, Padalhin AR, Faruq O, Sultana T, Lee BT. In vitro and in vivo evaluation of bioglass microspheres incorporated brushite cement for bone regeneration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 103:109775. [DOI: 10.1016/j.msec.2019.109775] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 05/04/2019] [Accepted: 05/17/2019] [Indexed: 01/15/2023]
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Karfarma M, Esnaashary MH, Rezaie HR, Javadpour J, Naimi-Jamal MR. Poly(propylene fumarate)/magnesium calcium phosphate injectable bone composite: Effect of filler size and its weight fraction on mechanical properties. Proc Inst Mech Eng H 2019; 233:1165-1174. [PMID: 31545134 DOI: 10.1177/0954411919877277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to produce a composite of poly(propylene fumarate)/magnesium calcium phosphate as a substitutional implant in the treatment of trabecular bone defects. So, the effect of magnesium calcium phosphate particle size, magnesium calcium phosphate:poly(propylene fumarate) weight ratio on compressive strength, Young's modulus, and toughness was assessed by considering effective fracture mechanisms. Micro-sized (∼30 µm) and nano-sized (∼50 nm) magnesium calcium phosphate particles were synthesized via emulsion precipitation and planetary milling methods, respectively, and added to poly(propylene fumarate) up to 20 wt.%. Compressive strength, Young's modulus, and toughness of the composites were measured by compressive test, and effective fracture mechanisms were evaluated by imaging fracture surface. In both micro- and nano-composites, the highest compressive strength was obtained by adding 10 wt.% magnesium calcium phosphate particles, and the enhancement in nano-composite was superior to micro-one. The micrographs of fracture surface revealed different mechanisms such as crack pinning, void plastic growth, and particle cleavage. According to the results, the produced composite can be considered as a candidate for substituting hard tissue.
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Affiliation(s)
- Masoud Karfarma
- School of Metallurgy and Materials Engineering, Iran University of Science and Technology, Tehran, Iran
| | | | - Hamid Reza Rezaie
- School of Metallurgy and Materials Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Jafar Javadpour
- School of Metallurgy and Materials Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Mohammad Reza Naimi-Jamal
- Research Laboratory of Green Organic Synthesis and Polymers, Department of Chemistry, Iran University of Science and Technology, Tehran, Iran
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Bavya Devi K, Nandi SK, Roy M. Magnesium Silicate Bioceramics for Bone Regeneration: A Review. J Indian Inst Sci 2019. [DOI: 10.1007/s41745-019-00119-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Brueckner T, Heilig P, Jordan MC, Paul MM, Blunk T, Meffert RH, Gbureck U, Hoelscher-Doht S. Biomechanical Evaluation of Promising Different Bone Substitutes in a Clinically Relevant Test Set-Up. MATERIALS 2019; 12:ma12091364. [PMID: 31035473 PMCID: PMC6540007 DOI: 10.3390/ma12091364] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/20/2019] [Accepted: 04/23/2019] [Indexed: 12/02/2022]
Abstract
(1) Background: Bone substitutes are essential in orthopaedic surgery to fill up large bone defects. Thus, the aim of the study was to compare diverse bone fillers biomechanically to each other in a clinical-relevant test set-up and to detect differences in stability and handling for clinical use. (2) Methods: This study combined compressive strength tests and screw pullout-tests with dynamic tests of bone substitutes in a clinical-relevant biomechanical fracture model. Beyond well-established bone fillers (ChronOSTM Inject and Graftys® Quickset), two newly designed bone substitutes, a magnesium phosphate cement (MPC) and a drillable hydrogel reinforced calcium phosphate cement (CPC), were investigated. (3) Results: The drillable CPC revealed a comparable displacement of the fracture and maximum load to its commercial counterpart (Graftys® Quickset) in the clinically relevant biomechanical model, even though compressive strength and screw pullout force were higher using Graftys®. (4) Conclusions: The in-house-prepared cement allowed unproblematic drilling after replenishment without a negative influence on the stability. A new, promising bone substitute is the MPC, which showed the best overall results of all four cement types in the pure material tests (highest compressive strength and screw pullout force) as well as in the clinically relevant fracture model (lowest displacement and highest maximum load). The low viscosity enabled a very effective interdigitation to the spongiosa and a complete filling up of the defect, resulting in this demonstrated high stability. In conclusion, the two in-house-developed bone fillers revealed overall good results and are budding new developments for clinical use.
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Affiliation(s)
- Theresa Brueckner
- Department for Functional Materials in Medicine and Dentistry, University of Wuerzburg, Pleicherwall 2, 97070 Wuerzburg, Germany.
| | - Philipp Heilig
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany.
| | - Martin Cornelius Jordan
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany.
| | - Mila Marie Paul
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany.
| | - Torsten Blunk
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany.
| | - Rainer Heribert Meffert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany.
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University of Wuerzburg, Pleicherwall 2, 97070 Wuerzburg, Germany.
| | - Stefanie Hoelscher-Doht
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany.
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Cao W, Zong S, Zhang Y, Qiu F, Tang J, Wu Z, Luan J. Preparation of a novel bone wax with modified tricalcium silicate cement and BGs. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 99:979-985. [PMID: 30889773 DOI: 10.1016/j.msec.2019.02.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 01/15/2019] [Accepted: 02/14/2019] [Indexed: 10/27/2022]
Abstract
Amino-grafted and vaterite-contained tricalcium silicate cement (A-V-C3S) was composited with 58S bioglass/chitosan/carboxy methyl cellulose (BG/CS/CMC, referred as BGs) to surmount the non-absorbability and infection problems of traditional bone wax. Its material, bioactive, biocompatible and antibacterial properties were systematically characterized. The results revealed that A-V-C3S/BGs possessed self-setting, injectable, mechanical and degradable abilities. A-V-C3S/BGs (1:1 g/g) was optimum owing to its higher compressive strength (9.91 MPa) and lower pH value (7.6 to 8.1) in the test groups. In vitro immersion experiment demonstrated that A-V-C3S/BGs had good hydroxyapatite formation ability, and its excellent cell adhesion, low cytotoxicity and superior cell proliferation were verified by mouse embryonic osteoblast precursor cells in cell tests. Compared with A-V-C3S, antibacterial experiment illustrated the significantly enhanced antibacterial property of A-V-C3S/BGs to Staphylococcus aureus and Escherichia coli.
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Affiliation(s)
- Weijing Cao
- College of Materials Science and Engineering, Nanjing Tech University, Nanjing 210009, China
| | - Shouyang Zong
- Department of Clinical Laboratory, People's Hospital of Jinhu Country, China
| | - Yin Zhang
- College of Materials Science and Engineering, Nanjing Tech University, Nanjing 210009, China; Nanjing Haoqi Advanced Materials Co., Ltd., Nanjing 211300, China.
| | - Fan Qiu
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China; The State Key Laboratory of Pharmaceutical Biotechnology, College of Life Science, Nanjing University, Nanjing 210093, China
| | - Jun Tang
- College of Materials Science and Engineering, Nanjing Tech University, Nanjing 210009, China
| | - Zhenning Wu
- College of Materials Science and Engineering, Nanjing Tech University, Nanjing 210009, China
| | - Jiapan Luan
- College of Materials Science and Engineering, Nanjing Tech University, Nanjing 210009, China
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Luo W, Geng Z, Li Z, Wu S, Cui Z, Zhu S, Liang Y, Yang X. Controlled and sustained drug release performance of calcium sulfate cement porous TiO 2 microsphere composites. Int J Nanomedicine 2018; 13:7491-7501. [PMID: 30532535 PMCID: PMC6241695 DOI: 10.2147/ijn.s177784] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background Calcium sulphate cement (CSC) is widely used as an osteoconductive biomaterial in bone repair and regeneration. Purpose In this study, porous TiO2 microspheres were added to CSC to achieve a controlled and sustained drug (gentamicin) release. Methods Scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray powder diffraction (XRD), and Brunauer-Emmett-Teller (BET) surface area analysis were conducted to analyse the morphology, phase composition, and surface area of the TiO2 micro-spheres and composite cements. In addition, the injection time, compressive strength, degradation behaviour, and antibacterial ability of the composite cements were examined during in vitro degradation. Gentamicin release profile was recorded using an ultraviolet spectrophotometer. Results The results revealed the excellent drug loading ability of the TiO2 microspheres. The addition of TiO2 microspheres improved the injectability and compressive strength of the composite cements, the maximum value of which was achieved at a TiO2 loading of 5 wt.%. When immersed in simulated body fluid (SBF), the composite cements doped with TiO2 microspheres were observed to release gentamicin in a stable and sustained manner, especially in the latter stages of in vitro degradation. During degradation, CSC doped with TiO2 microspheres exhibited a typical apatite-like behaviour. Further, antibacterial analysis showed that CSC doped with TiO2 microspheres exhibited long-term antibiotic activity. Conclusion Thus, as an effective sustained-release formulation material, TiO2 microspheres show a great potential for application in bone cements.
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Affiliation(s)
- Wei Luo
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Tianjin, China,
| | - Zhen Geng
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Tianjin, China,
| | - Zhaoyang Li
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Tianjin, China,
| | - Shuilin Wu
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Tianjin, China,
| | - Zhenduo Cui
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Tianjin, China,
| | - Shengli Zhu
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Tianjin, China,
| | - Yanqin Liang
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Tianjin, China,
| | - Xianjin Yang
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Tianjin, China,
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Luo J, Engqvist H, Persson C. A ready-to-use acidic, brushite-forming calcium phosphate cement. Acta Biomater 2018; 81:304-314. [PMID: 30291976 DOI: 10.1016/j.actbio.2018.10.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 09/07/2018] [Accepted: 10/01/2018] [Indexed: 10/28/2022]
Abstract
Premixed calcium phosphate cements have been developed to simplify the usage of traditional calcium phosphate cements and reduce the influence of the setting reaction on the delivery process. However, difficulties in achieving a good cohesion, adequate shelf life and sufficient mechanical properties have so far impeded their use in clinical applications, especially for the more degradable acidic calcium phosphate cements. In this study, a brushite cement was developed from a series of ready-to-use calcium phosphate pastes. The brushite cement paste was formed via mixing of a monocalcium phosphate monohydrate (MCPM) paste and a β-tricalcium phosphate (β-TCP) paste with good injectability and adequate shelf life. The MCPM paste was based on a water-immiscible liquid with two surfactants and the β-TCP paste on a sodium hyaluronate aqueous solution. The effect of citric acid as a retardant was assessed. Formulations with suitable amounts of citric acid showed good cohesion and mechanical performance with potential for future clinical applications. STATEMENT OF SIGNIFICANCE: Acidic calcium phosphate cements have attracted extensive attention as bone substitute materials due to their ability to resorb faster than basic calcium phosphate cements in vivo. However, traditionally, short working times and low mechanical strength have limited their clinical application. Premixed cements could simplify the clinical use as well as improve property reproducibility, but short shelf lives, low cohesion and low mechanical properties have restricted the development. In this study, an injectable ready-to-use two-phase system consisting of an MCPM paste and a β-TCP paste was developed based on acidic cement. It shows good cohesion, compressive strength and adequate shelf life, which has the potential to be used in a dual chamber system for simplified and fast filling of bone defects in a minimally invasive manner. This will reduce surgery time, decrease the risk of contamination and ensure repeatable results.
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Sato T, Shirosaki Y, Nagaya M, Asano Y, Nakano K, Nagashima H, Aizawa M, Kikuchi M. Preparation of anti-decay self-setting pastes of hydroxyapatite/collagen utilizing (3-glycidoxypropyl)trimethoxysilane. JOURNAL OF ASIAN CERAMIC SOCIETIES 2018; 6:322-331. [DOI: 10.1080/21870764.2018.1517712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Affiliation(s)
- Taira Sato
- Department of Applied Chemistry, Graduate School of Science and Technology, Meiji University, Kawasaki, Japan
| | - Yuki Shirosaki
- Department of Materials Science, Faculty of Engineering, Kyushu Institute of Technology, Fukuoka, Japan
| | - Masaki Nagaya
- Meiji University International Institute for Bio-Resource Research, Meiji University, Kawasaki, Japan
| | - Yoshinori Asano
- Department of Life Sciences, School of Agriculture, Meiji University, Kawasaki, Japan
| | - Kazuaki Nakano
- Department of Life Sciences, School of Agriculture, Meiji University, Kawasaki, Japan
| | - Hiroshi Nagashima
- Meiji University International Institute for Bio-Resource Research, Meiji University, Kawasaki, Japan
- Department of Life Sciences, School of Agriculture, Meiji University, Kawasaki, Japan
| | - Mamoru Aizawa
- Department of Applied Chemistry, Graduate School of Science and Technology, Meiji University, Kawasaki, Japan
| | - Masanori Kikuchi
- Bioceramics Group, National Institute for Materials Science, Tsukuba, Japan
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Rödel M, Teßmar J, Groll J, Gbureck U. Highly flexible and degradable dual setting systems based on PEG-hydrogels and brushite cement. Acta Biomater 2018; 79:182-201. [PMID: 30149213 DOI: 10.1016/j.actbio.2018.08.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/17/2018] [Accepted: 08/21/2018] [Indexed: 01/21/2023]
Abstract
With respect to the composition of natural bone, we established a degradable dual setting system of different poly(ethylene glycol) (PEG)-based hydrogels combined with a brushite cement. The idea was to reinforce the inorganic calcium phosphate mineral phase with an organic, polymeric phase to alter the cement's properties towards ductility and elasticity. Extremely flexible samples were produced via this dual setting approach with a fully reversible elasticity of the samples containing high molecular weight PEG-based hydrogel precursors. Using the decalcifying agent EDTA, the whole inorganic phase was dissolved due to Ca2+-complexation and dimensionally stable hydrogels were obtained, indicating a homogenous polymeric phase within the composites. This was also confirmed by SEM-analysis, where no discontinuities or agglomerations of the phase were observed. Additional XRD-measurements proved a significant influence of the coherent polymeric matrix on the conversion from β-TCP/MCPA to brushite with a decrease in signal intensity. The results confirmed a parallelly running process of setting reaction and gelation without an inhibition of the conversion to brushite and the formation of interpenetrating networks of hydrogel and cement. The strengths of this newly developed dual setting system are based on the material degradability as well as flexibility, which can be a promising tool for bone regeneration applications in non-load bearing craniomaxillofacial defects. STATEMENT OF SIGNIFICANCE Brushite based calcium phosphate cements (CPCs) are known as bone replacement materials, which degrade in vivo and are replaced by native bone. However, the pure inorganic material shows a brittle fracture behavior. Here, the addition of a polymeric phase can influence the mechanical properties to create more ductile and flexible materials. This polymeric phase should ideally form during cement setting by a polymerization reaction to achieve high polymer loads without altering cement viscosity and it should be degradable in vivo similar to the cement itself. Therefore, we developed a dual setting system based on simultaneous cement setting of brushite and lactide modified poly(ethylene glycol) dimethacrylate (PEG-PLLA-DMA)-based hydrogel. It was evident that the gels form a continuous phase within the cement after radical polymerization with a strong reduction of cement brittleness.
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Affiliation(s)
- Michaela Rödel
- Department for Functional Materials in Medicine and Dentistry and Bavarian Polymer Institute (BPI), Julius Maximilians University of Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Jörg Teßmar
- Department for Functional Materials in Medicine and Dentistry and Bavarian Polymer Institute (BPI), Julius Maximilians University of Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Jürgen Groll
- Department for Functional Materials in Medicine and Dentistry and Bavarian Polymer Institute (BPI), Julius Maximilians University of Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry and Bavarian Polymer Institute (BPI), Julius Maximilians University of Würzburg, Pleicherwall 2, 97070 Würzburg, Germany.
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Lee HJ, Kim B, Padalhin AR, Lee BT. Incorporation of chitosan-alginate complex into injectable calcium phosphate cement system as a bone graft material. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 94:385-392. [PMID: 30423721 DOI: 10.1016/j.msec.2018.09.039] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 08/04/2018] [Accepted: 09/12/2018] [Indexed: 11/17/2022]
Abstract
Calcium phosphate brushite type of cements have been used to replace bone graft materials because of their biocompatibility and other attractive features. Especially, injectability of cement allows easy handling of minimally invasive surgical techniques. New calcium phosphate cement (CPC) system, brushite based cement incorporated into polyelectrolyte complex, was developed in this study. Chitosan-alginate complex produced by an interaction between a cationic polymer (chitosan) and an anionic polymer (alginate) was loaded in the cement. This improved the functional properties and biocompatibility of the final cement. We optimized the liquid/solid (L/S) ratio of the cement components and investigated the compressive strength, setting time, pH change of CPC0 (with only citric acid) and CPC0.5, 1, and 1.5 (0.5, 1, and 1.5 v/v % chitosan-alginate complex in citric acid solution, respectively). The L/S ratio did not affect structural formation, while the addition of polymer complex showed new formation of macro-pores within CPC. However, a lower L/S ratio and higher amount of added polymer complex shortened the setting time and improved the compressive strength. The appropriate conditions for the injectable bone substitute were CPC1 with an L/S ratio of 0.45. To investigate the effect of the chitosan-alginate complex on CPC system in physiological conditions, CPC0 and CPC1 were implanted in a rabbit femoral head defect model for 1 and 3 months. Micro-computed tomography revealed improved bone formation in CPC1 compared to CPC0 3 months after implantation. Histological analysis revealed newly formed bone tissues around the peripheral sides of CPC0 and CPC1. The results indicate the potential value of the CPC system containing polymer complex as an injectable bone substitute. The study of the CPC-polymer complex system incorporating drugs or cells can be further developed into a controlled release system for faster bone regeneration.
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Affiliation(s)
- Hyun-Jung Lee
- Department of Regenerative Medicine, College of Medicine, Soonchunhyang University, South Korea
| | - Boram Kim
- Institute of Tissue Regeneration, College of Medicine, Soonchunhyang University, South Korea
| | - Andrew R Padalhin
- Institute of Tissue Regeneration, College of Medicine, Soonchunhyang University, South Korea
| | - Byong-Taek Lee
- Department of Regenerative Medicine, College of Medicine, Soonchunhyang University, South Korea; Institute of Tissue Regeneration, College of Medicine, Soonchunhyang University, South Korea.
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Bone regeneration capacity of magnesium phosphate cements in a large animal model. Acta Biomater 2018; 69:352-361. [PMID: 29409867 DOI: 10.1016/j.actbio.2018.01.035] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/18/2018] [Accepted: 01/23/2018] [Indexed: 12/21/2022]
Abstract
Magnesium phosphate minerals have captured increasing attention during the past years as suitable alternatives for calcium phosphate bone replacement materials. Here, we investigated the degradation and bone regeneration capacity of experimental struvite (MgNH4PO4·6H2O) forming magnesium phosphate cements in two different orthotopic ovine implantation models. Cements formed at powder to liquid ratios (PLR) of 2.0 and 3.0 g ml-1 were implanted into trabecular bone using a non-load-bearing femoral drill-hole model and a load-bearing tibial defect model. After 4, 7 and 10 months the implants were retrieved and cement degradation and new bone formation was analyzed by micro-computed tomography (µCT) and histomorphometry. The results showed cement degradation in concert with new bone formation at both defect locations. Both cements were almost completely degraded after 10 months. The struvite cement formed with a PLR of 2.0 g ml-1 exhibited a slightly accelerated degradation kinetics compared to the cement with a PLR of 3.0 g ml-1. Tartrat-resistant acid phosphatase (TRAP) staining indicated osteoclastic resorption at the cement surface. Energy dispersive X-ray analysis (EDX) revealed that small residual cement particles were mostly accumulated in the bone marrow in between newly formed bone trabeculae. Mechanical loading did not significantly increase bone formation associated with cement degradation. Concluding, struvite-forming cements might be promising bone replacement materials due to their good degradation which is coupled with new bone formation. STATEMENT OF SIGNIFICANCE Recently, the interest in magnesium phosphate cements (MPC) for bone substitution increased, as they exhibit high initial strength, comparably elevated degradation potential and the release of valuable magnesium ions. However, only few in vivo studies, mostly including non-load-bearing defects in small animals, have been performed to analyze the degradation and regeneration capability of MPC derived compounds. The present study examined the in vivo behavior of magnesiumammoniumphosphate hexahydrate (struvite) implants with different porosity in both mechanically loaded and non-loaded defects of merino sheep. For the first time, the effect of mechanical stimuli on the biological outcome of this clinically relevant replacement material is shown and directly compared to the conventional unloaded defect situation in a large animal model.
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