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Ma M, Shen W, Li B, Sun M, Lin D, Meng L. Optimization of a concentrated growth factor/mesoporous bioactive glass composite scaffold and its application in rabbit mandible defect regeneration. Biomater Sci 2023; 11:6357-6372. [PMID: 37584200 DOI: 10.1039/d3bm00805c] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
Maxillofacial bone defect repair and regeneration remains a tremendous challenge in the field of stomatology. However, the limited osteoinductivity of artificial materials and the high cost of bioactive agents restrain their clinical translation. This study aimed to construct an economical and efficient concentrated growth factor/mesoporous bioactive glass (CGF/MBG) composite scaffold for bone regeneration. The biochemical composition and biological effects of different forms of CGFs were systematically compared, and the results showed that CGF-conditioned medium effectively promoted proliferation, migration and osteogenesis of allogenic BMSCs. Gel phase CGF (gpCGF) exhibited superior bioactivity and osteoinductivity to liquid phase CGF (lpCGF) and liquid/gel mixed phase CGF (lgpCGF), and was further applied to construct CGF/MBG scaffolds. In vitro studies demonstrated that co-culture with gpCGF-conditioned medium further enhanced the biocompatibility of MBG, increasing cell adhesion and proliferation on the scaffold. On this basis, two compositing approaches to construct the scaffold by fibrin gel formation (CGF/FG/MBG) and freeze-drying (fdCGF/MBG) were applied, and the biological efficacy of CGFs was compared in vivo. In a rabbit mandibular defect model, higher osteogenic efficiency in in situ bone regeneration of CGF/FG/MBG composite scaffolds was proved, compared with fdCGF/MBG. Taken together, the CGF/FG/MBG composite scaffold is expected to be an efficient bone repairing therapy for clinical translation, and the CGF-composited scaffold using gpCGF and the fibrin gel formation method is a promising way to enhance the bioactivity and osteoinductivity of current clinical bone repairing materials, providing new thoughts on the development of future orthopedic biomaterials.
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Affiliation(s)
- Mengran Ma
- Department of Prosthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China.
| | - Wenjing Shen
- Department of Prosthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China.
| | - Beibei Li
- Department of Prosthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China.
| | - Mengwen Sun
- Department of Prosthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China.
| | - Dan Lin
- Shanghai University of Medicine and Health Sciences, Shanghai 201318, PR China.
| | - Lingqiang Meng
- Department of Prosthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China.
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Zhao H, Wang X, Jin A, Wang M, Wang Z, Huang X, Dai J, Wang X, Lin D, Shen SGF. Reducing relapse and accelerating osteogenesis in rapid maxillary expansion using an injectable mesoporous bioactive glass/fibrin glue composite hydrogel. Bioact Mater 2022; 18:507-525. [PMID: 35415307 PMCID: PMC8976096 DOI: 10.1016/j.bioactmat.2022.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 02/24/2022] [Accepted: 03/01/2022] [Indexed: 11/29/2022] Open
Abstract
Rapid maxillary expansion (RME), as a common treatment for craniomaxillofacial deformity, faces the challenge of high relapse rates and unsatisfactory therapeutic effects. In this study, a standardized Sprague-Dawley (SD) rat RME model was first established with a modified expander as well as retainer design and optimized anterior maxillary expanding force of 100 g which exerted the most synchronized mobility of mid-palatal suture and incisors. Via the standardized model, the high relapse rate was proven to be attributed to insufficient osteogenesis in expanded suture, requiring long-term retainer wearing in clinical situations. To reduce the relapse rate, mesoporous bioactive glass/fibrin glue (MBG/FG) composite hydrogels were developed for an in situ minimal invasive injection that enhance osteogenesis in the expanded palate. The component of 1 wt% MBG was adopted for enhanced mechanical strength, matched degradation rate and ion dissolution, excellent in vitro biocompatibility and osteoinductivity. Effects of 1%MBG/FG composite hydrogel on osteogenesis in expanded mid-palatal sutures with/without retention were evaluated in the standardized model. The results demonstrated that injection of 1%MBG/FG composite hydrogel significantly promoted bone formation within the expanded mid-palatal suture, inhibited osteoclastogenesis and benefited the balance of bone remodeling towards osteogenesis. Combination of retainer and injectable biomaterial was demonstrated as a promising treatment to reduce relapse rate and enhance osteogenesis after RME. The model establishment and the composite hydrogel development in this article might provide new insight to other craniomaxillofacial deformity treatment and design of bone-repairing biomaterials with higher regenerative efficiency. A standardized rat RME model was established with optimized parameters. Sufficient osteogenesis was the prerequisite of reducing relapse ratio. Design of an injectable MBG/FG composite hydrogel for osteogenic enhancement. Combinatory treatment of injection and retention was developed for relapse reduction.
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Tu C, Bajwa A, Shi A, Wu G, Wang J. Effect of fibrin glue on the healing efficacy of deproteinized bovine bone and autologous bone in critical-sized calvarial defects in rats. Clin Oral Investig 2022; 26:2491-2502. [DOI: 10.1007/s00784-021-04217-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 09/30/2021] [Indexed: 11/24/2022]
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Banyatworakul P, Pirarat N, Sirisawadi S, Osathanon T, Kalpravidh C. Efficacy of bubaline blood derived fibrin glue in silk ligature-induced acute periodontitis in Wistar rats. Vet World 2021; 14:2602-2612. [PMID: 34903915 PMCID: PMC8654744 DOI: 10.14202/vetworld.2021.2602-2612] [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: 05/07/2021] [Accepted: 08/20/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND AND AIM Fibrin forms in the coagulation process, enhancing local hemostatic properties and promoting wound healing. The study aimed to evaluate the efficacy of bubaline-derived fibrin glue in silk ligature-induced periodontitis rats. MATERIALS AND METHODS Bubaline blood-derived fibrin glue was prepared using cryoprecipitation and cryocentrifugation. Periodontitis was induced in rats by placing 5-0 silk ligatures around the mandibular first molars. The animals were divided into two groups: (1) Non-treatment and (2) bubaline fibrin glue-treated groups. Plaque, gingival inflammation, and mobility index were scored on days 1, 7, and 14 after intervention. Histological examinations were performed. The mRNA expression of inflammatory cytokines and growth factors was evaluated using a real-time polymerase chain reaction. Ligature-induced periodontitis was confirmed by the increase in inflammatory cell infiltration as well as histological bone and attachment loss. RESULTS Compared to the non-treatment group, bubaline fibrin glue application reduced mononuclear cell infiltration into periodontal tissues corresponding to the reduction of collagen destruction. On days 7 and 14 after intervention, the inflammatory score and histological attachment loss were significantly lower in the bubaline fibrin glue-treated group than in the non-treatment group. A significant reduction in histological bone loss was observed in the treated group on day 7. Bubaline fibrin glue application led to a significant reduction of Tnfa and Il1b mRNA levels, while an increased expression of Pdgfa, Tgfb1, and Il10 was observed compared with the control. CONCLUSION Bubaline fibrin glue could be beneficial in periodontitis treatment aiming to reduce inflammation and delay the progression of periodontal disease.
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Affiliation(s)
- Poranee Banyatworakul
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Nopadon Pirarat
- Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Sujin Sirisawadi
- Biochemistry Unit, Department of Veterinary Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Thanaphum Osathanon
- Dental Stem Cell Biology Research Unit, Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Chanin Kalpravidh
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330 Thailand
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Ramanathan M, Tiwari RK, Mohan SP, Shankar DP, Bagadia RK, Varma PRH, Fernandez FB, Babu SS. Utility of Chitra-HASi Granules in Cystic Defects of the Maxillofacial Region: A Pilot Study. J Pharm Bioallied Sci 2021; 13:S772-S777. [PMID: 34447199 PMCID: PMC8375829 DOI: 10.4103/jpbs.jpbs_816_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 12/02/2022] Open
Abstract
Background: Cystic defects that are critical sized or larger require bone replacement strategies. However, due to inherent disadvantages of the various types of grafts, none of the available materials are best suited for these defects. Among the alloplastic materials, hydroxyapatite (HA)-based grafts are the most popular, due to their osteoconductive nature and resemblance to mineral bone. The aim of the study was to assess the utility of the novel material “Chitra-HASi” as a bone substitute in the maxillofacial region. Materials and Methods: In a single-arm, prospective study, patients with radicular and dentigerous cysts were included and the minimum defect size was standardized at 20 × 20 mm or above. The Chitra–HASi material was developed by a wet precipitation technique and adopted for use following multiple in vitro and in vivo studies, confirming its safety and biocompatibility profile. All cysts underwent enucleation, followed by peripheral ostectomy and apicectomy of the teeth involved. The HASi graft was packed inside the cystic defect in a granular form and covered with a mucoperiosteal flap. Panoramic radiographs were taken preoperatively and at 3, 6, and 12 months postoperatively. Results: Twenty-three patients were included in the study, of which only 10 patients could be followed up for 12 months after graft placement. The mean preoperative bone density was found to be 14.9% ± 4.97 (standard deviation), whereas the postoperative 3-month, 6-month, and 12-month densities had a mean difference of −11.3%, −22.9%, and −37.3%, respectively, and the differences were statistically significant. Minor complications such as sinus formation (n = 7) and extrusion of granules (n = 4) were noted, which were managed conservatively. Only two patients required graft removal secondary to infection, leading to a persistent sinus tract. Conclusion: The results of the study suggest that Chitra–HASi granules show potential as an alternative to other bone substitutes. The addition of silica to the porous HA material offers superior strength characteristics and needs long-term evaluation to assess its stability in large cystic defects.
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Affiliation(s)
- Manikandhan Ramanathan
- Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India.,Meenakshi Cleft and Craniofacial Centre, Meenakshi Academy of Higher Education and Research (Deemed-to-be University), Chennai, Tamil Nadu, India
| | - Raj Kumar Tiwari
- Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India.,Department of Oral and Maxillofacial Surgery, Ex-servicemen Contributory Health Scheme (ECHS), Sagar, Madhya Pradesh, India
| | - Sunil Paramel Mohan
- Department of Oral Pathology, Sree Anjaneya Institute of Dental Sciences, Atholi, Calicut, Kerala, India
| | - Dayasankar Prabhu Shankar
- Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Ritvi K Bagadia
- Meenakshi Cleft and Craniofacial Centre, Meenakshi Academy of Higher Education and Research (Deemed-to-be University), Chennai, Tamil Nadu, India
| | - P R Harikrishna Varma
- Division of Bioceramics, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Francis Boniface Fernandez
- Division of Bioceramics, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - S Suresh Babu
- Division of Bioceramics, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
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Theodoridis K, Manthou ME, Aggelidou E, Kritis A. In Vivo Cartilage Regeneration with Cell-Seeded Natural Biomaterial Scaffold Implants: 15-Year Study. TISSUE ENGINEERING PART B-REVIEWS 2021; 28:206-245. [PMID: 33470169 DOI: 10.1089/ten.teb.2020.0295] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Articular cartilage can be easily damaged from human's daily activities, leading to inflammation and to osteoarthritis, a situation that can diminish the patients' quality of life. For larger cartilage defects, scaffolds are employed to provide cells the appropriate three-dimensional environment to proliferate and differentiate into healthy cartilage tissue. Natural biomaterials used as scaffolds, attract researchers' interest because of their relative nontoxic nature, their abundance as natural products, their easy combination with other materials, and the relative easiness to establish Marketing Authorization. The last 15 years were chosen to review, document, and elucidate the developments on cell-seeded natural biomaterials for articular cartilage treatment in vivo. The parameters of the experimental designs and their results were all documented and presented. Considerations about the newly formed cartilage and the treatment of cartilage defects were discussed, along with difficulties arising when applying natural materials, research limitations, and tissue engineering approaches for hyaline cartilage regeneration.
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Affiliation(s)
- Konstantinos Theodoridis
- Department of Physiology and Pharmacology, Faculty of Health Sciences and cGMP Regenerative Medicine Facility, School of Medicine, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Maria Eleni Manthou
- Laboratory of Histology, Embryology, and Anthropology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Eleni Aggelidou
- Department of Physiology and Pharmacology, Faculty of Health Sciences and cGMP Regenerative Medicine Facility, School of Medicine, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Aristeidis Kritis
- Department of Physiology and Pharmacology, Faculty of Health Sciences and cGMP Regenerative Medicine Facility, School of Medicine, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
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Jang CH, Cho GW, Song AJ. Effect of Bone Powder/Mesenchymal Stem Cell/BMP2/Fibrin Glue on Osteogenesis in a Mastoid Obliteration Model. In Vivo 2021; 34:1103-1110. [PMID: 32354898 DOI: 10.21873/invivo.11881] [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: 01/27/2020] [Revised: 03/02/2020] [Accepted: 03/05/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM This study aimed to prospectively compare the osteogenesis of bone powder (BP) substances with and without mesenchymal stem cells (MSCs) and evaluate the synergistic effect of topically applied recombinant human bone morphogenic protein-2 (BMP2) on MSC-loaded BP using fibrin glue in a mastoid obliteration model. MATERIALS AND METHODS To determine the expression of osteocyte-specific genes, total RNA was isolated from three MSC groups: Untreated MSCs, MSCs cultured with BP, and MSCs cultured with BP and BMP2. Real-time polymerase chain reaction was carried out with specific primers of osteogenesis-related genes runt-related transcription factor 2, osteocalcin, osteoprotegerin, osterix, alkaline phosphatase, transforming growth factor beta, and type I collagen. Live/dead staining was also performed. To observe the adhesion of MSCs to the BP, MSCs were treated with BP for 2 days and the surface was observed by scanning electron microscopy (SEM). Under general anesthesia, mastoid obliteration was performed in rats using three groups: treated with BP alone, BP/MSCs, and BP/MSC/BMP2. Before decapitation at 8 weeks post operation, in vivo micro computed tomography (micro CT) was performed. The bullae were dissected, fixed, and decalcified. followed by dehydration, paraffin embedding, and staining by hematoxylin and eosin and Masson's trichrome. RESULTS SEM showed the MSCs to be well-attached to the superficial area of the BP. The expression of osteocyte-specific genes was the highest in the MSCs cultured with BP and BMP2, followed by cultured with BP only, and untreated MSCs. The BP/MSC/BMP2 group showed the highest radiodensity of bullae in microCT analysis. The microCT findings revealed that the BP/MSC/BMP2 group showed the most enhanced osteogenesis of the scaffold compared to the other two groups. No significant difference was found in osteoconductive osteogenesis between the control and BP/MSC groups. However, the BP/MSC/BMP2 group showed significantly enhanced osteoconductive osteogenesis and osteoinductive change of the BP as shown by hematoxylin and eosin staining. Histomorphometry of osteogenesis revealed that the difference between the BP/MSC/BMP2 group and the other two groups was statistically significant. CONCLUSION A small amount of BMP2 is necessary during MSC loading to enhance the osteogenesis of BP and avoid complications associated with high doses of BMP2. These results may be applicable to mastoid obliteration in clinical practice.
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Affiliation(s)
- Chul Ho Jang
- Department of Otolaryngology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Gwang Won Cho
- Department of Biology, College of Natural Science, Chosun University, Gwangju, Republic of Korea.,Department of Life Science, BK-21-Plus Research Team for Bioactive Control Technology, Chosun University, Gwangju, Republic of Korea
| | - An-Ji Song
- Department of Biology, College of Natural Science, Chosun University, Gwangju, Republic of Korea.,Department of Life Science, BK-21-Plus Research Team for Bioactive Control Technology, Chosun University, Gwangju, Republic of Korea
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Pathmanapan S, Periyathambi P, Anandasadagopan SK. Fibrin hydrogel incorporated with graphene oxide functionalized nanocomposite scaffolds for bone repair — In vitro and in vivo study. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2020; 29:102251. [DOI: 10.1016/j.nano.2020.102251] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 10/24/2022]
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9
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Torkian P, Daneshvar K, Taherian E, Rezaeifar Y, Akhlaghpoor S. Fibrin sealants in lumbar annuloplasty after endoscopic discectomy as a method to prevent recurrent lumbar disc herniation. Eur J Transl Myol 2020; 30:8748. [PMID: 32782757 PMCID: PMC7385697 DOI: 10.4081/ejtm.2019.8748] [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: 12/10/2019] [Accepted: 01/24/2020] [Indexed: 11/23/2022] Open
Abstract
Fibrin sealant as a promising agent for providing scaffold and efficient hemostasis is widely accepted in several specialties. However, the outcome of Fibrin sealants in lumbar annuloplasty after endoscopic discectomy has not been evaluated in patients with disc herniation. The goal of this study was to evaluate the efficacy, response, and probability of future recurrence rates in herniated nucleus pulposus (HNP) with the use of fibrin sealant in conjunction with endoscopic disc surgery. A total of 35 patients (28 men, 7women) were evaluated, including 18 patients who underwent endoscopic discectomy alone and 17 patients that received fibrin sealant at the site of annulus tear and endoscopic discectomy. All patients were followed through both clinical and imaging methods for an average of 10.5 months. Primary outcome measure was defined as lumbar decompression approved by imaging and symptom alleviation after endoscopic spinal discectomy with Visual Analogue Scale (VAS) score ≤ 4 (cut-off point). Median size of annular tearing was significantly lower in the endoscopic discectomy group (median, 3) (minimum, 2; maximum, 5); however, the corresponding factor in the endoscopic discectomy plus fibrin sealant group was significantly larger (median, 6) (minimum, 5; maximum, 10), with P <0.001. Only one patient in the endoscopic discectomy group had an HNP recurrence during follow-up compared to two patients in the endoscopic discectomy plus fibrin sealant group. Due to the temporary effects of fibrin sealant in preventing disc herniation and the observed recurrence rate in both the case and control groups, the results of this study suggest a role of fibrin sealants combined with endoscopic discectomy to prevent early HNP recurrence rate.
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Affiliation(s)
- Pooya Torkian
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Keivan Daneshvar
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Yasaman Rezaeifar
- Department of Psychology, Faculty of Health, York University, Toronto, Ontario, Canada
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Torkian P, Daneshvar K, Taherian E, Rezaeifar Y, Akhlaghpoor S. Fibrin sealants in lumbar annuloplasty after endoscopic discectomy as a method to prevent recurrent lumbar disc herniation. Eur J Transl Myol 2020. [DOI: 10.4081/ejtm.2020.8748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Fibrin sealant as a promising agent for providing scaffold and efficient hemostasis is widely accepted in several specialties. However, the outcome of Fibrin sealants in lumbar annuloplasty after endoscopic discectomy has not been evaluated in patients with disc herniation. The goal of this study was to evaluate the efficacy, response, and probability of future recurrence rates in herniated nucleus pulposus (HNP) with the use of fibrin sealant in conjunction with endoscopic disc surgery. A total of 35 patients (28 men, 7women) were evaluated, including 18 patients who underwent endoscopic discectomy alone and 17 patients that received fibrin sealant at the site of annulus tear and endoscopic discectomy. All patients were followed through both clinical and imaging methods for an average of 10.5 months. Primary outcome measure was defined as lumbar decompression approved by imaging and symptom alleviation after endoscopic spinal discectomy with Visual Analogue Scale (VAS) score ≤ 4 (cut-off point). Median size of annular tearing was significantly lower in the endoscopic discectomy group (median, 3) (minimum, 2; maximum, 5); however, the corresponding factor in the endoscopic discectomy plus fibrin sealant group was significantly larger (median, 6) (minimum, 5; maximum, 10), with P <0.001. Only one patient in the endoscopic discectomy group had an HNP recurrence during follow-up compared to two patients in the endoscopic discectomy plus fibrin sealant group. Due to the temporary effects of fibrin sealant in preventing disc herniation and the observed recurrence rate in both the case and control groups, the results of this study suggest a role of fibrin sealants combined with endoscopic discectomy to prevent early HNP recurrence rate.
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Gong Y, Zhang Y, Cao Z, Ye F, Lin Z, Li Y. Development of CaCO 3 microsphere-based composite hydrogel for dual delivery of growth factor and Ca to enhance bone regeneration. Biomater Sci 2020; 7:3614-3626. [PMID: 31210206 DOI: 10.1039/c9bm00463g] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Injectable scaffolds have attracted much attention because of their minimum surgical invasiveness. However, limited osteogenic induction property and low mechanical properties hampered their application in bone tissue engineering. CaCO3 microspheres, which possess osteoinductivity, rough surfaces and specific binding sites for BMP-2, were first fabricated; after BMP-2 uploading, microspheres were further entrapped in fibrin-glue hydrogel. CaCO3 microspheres were co-functionalized with casein and heparin. To obtain a high encapsulation of heparin and thus BMP-2 uploading, along with controlled release and simultaneous maintenance of the presence of vaterite which had osteogenic induction property, fabrication parameters were optimized and microspheres were characterized using XRD, FITR and SEM. The formed CaCO3 had a microsphere morphology of ∼1 μm. Both vaterite and calcite phases were present and the relative amount of calcite phase increased with the amount of heparin. Sample 25 mM_4-1Hep with the highest loading amount of heparin was selected as carrier for BMP-2 and BMP-2 loaded CaCO3 microspheres were further entrapped in fibrin-glue hydrogel (FC-B). For the as-prepared composite hydrogel, mechanical properties were characterized and the presence of CaCO3 significantly elevated the tensile strength; controlled release of BMP-2 was sustained until day 21. Based on ALP activity, alizarin red staining and RT-PCR, in vitro osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) was found to be significantly enhanced under induction of FC-B. Rabbit tibia bone defect model was applied to evaluate its in vivo performance. After implantation for 4 weeks, presence of composite hydrogel was observed in defects. After 8 weeks, bone defects of FC-B group were nearly completely healed. Using the fact that autologous scaffolds can be derived based on fibrin-glue hydrogel, the well-designed BMP-2 loaded fibrin-glue composite hydrogel demonstrated good potential in bone tissue engineering.
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Affiliation(s)
- Yihong Gong
- Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instrument, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China.
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Dorozhkin SV. Functionalized calcium orthophosphates (CaPO 4) and their biomedical applications. J Mater Chem B 2019; 7:7471-7489. [PMID: 31738354 DOI: 10.1039/c9tb01976f] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Due to the chemical similarity to natural calcified tissues (bones and teeth) of mammals, calcium orthophosphates (abbreviated as CaPO4) appear to be good biomaterials for creation of artificial bone grafts. However, CaPO4 alone have some restrictions, which limit their biomedical applications. Various ways have been developed to improve the properties of CaPO4 and their functionalization is one of them. Namely, since surfaces always form the interfaces between implanted grafts and surrounding tissues, the state of CaPO4 surfaces plays a crucial role in the survival of bone grafts. Although the biomedically relevant CaPO4 possess the required biocompatible properties, some of their properties could be better. For example, functionalization of CaPO4 to enhance cell attachment and cell material interactions has been developed. In addition, to prepare stable formulations from nanodimensional CaPO4 particles and prevent them from agglomerating, the surfaces of CaPO4 particles are often functionalized by sorption of special chemicals. Furthermore, there are functionalizations in which CaPO4 are exposed to various types of physical treatments. This review summarizes the available knowledge on CaPO4 functionalizations and their biomedical applications.
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Do the Fibrin Scaffold and Growth Factors in Platelet-Rich Fibrin Play the Most Vital Roles in Bone Regeneration? A Critical Comment. J Craniofac Surg 2019; 30:1923-1926. [DOI: 10.1097/scs.0000000000005487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Mehrabani D, Khodakaram-Tafti A, Shaterzadeh-Yazdi H, Zamiri B, Omidi M. Comparison of the regenerative effect of adipose-derived stem cells, fibrin glue scaffold, and autologous bone graft in experimental mandibular defect in rabbit. Dent Traumatol 2018; 34:413-420. [PMID: 30187637 DOI: 10.1111/edt.12435] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 08/30/2018] [Accepted: 08/30/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND/AIMS One of the main concerns for maxillofacial and orthopedic surgeons is finding a method to improve regeneration of large craniofacial bone defects. The aim of this study was to investigate the healing and regenerative effects of fibrin glue associated with adipose-derived stem cells (ADSCs) and fibrin glue scaffold alone with autologous bone grafts in experimental mandibular defects of the rabbit. METHODS Bilateral uni-cortical osteotomies were performed in the mandible of 20 male Dutch rabbits. The animals were randomly divided into 2 equal groups. In one group, the defect on the right side was treated by fibrin glue associated with ADSCs and the defect on the other side remained as the control. In another group, the defect on the right side was treated with fibrin glue and on the left side with autologous bone graft. After 28 and 56 days, five rabbits from each group were evaluated by computed tomography (CT) and histopathological examinations. RESULTS Coronal CT showed a remarkable reconstruction of cortical bone in the fibrin glue associated with ADSCs group at 28 and 56 days post-surgery. Histopathologically, new cortical bony bridge formation was seen increasingly in the fibrin glue, fibrin glue associated with ADSCs, and autologous bone graft groups after 28 days. Statistical analysis of the thickness of new cortical bone in the treatment versus control groups showed a significant difference between fibrin glue alone and fibrin glue associated with ADSCs groups (P = 0.02). No significant difference was found between the fibrin glue associated with ADSCs and the autologous bone graft groups (P > 0.05). CONCLUSIONS The healing process had a significant increase in the thickness of new cortical bone when fibrin glue scaffold associated with ADSCs was used.
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Affiliation(s)
- Davood Mehrabani
- Stem Cell and Transgenic Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Barbad Zamiri
- Department of Craniomaxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Omidi
- Department of Oral and Maxillofacial Radiology and Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Batista JD, Justino Oliveira Limirio PH, Rocha FS, Gomes Moura CC, Zanetta-Barbosa D, Dechichi P. Influence of Platelet-Poor Plasma on Angiogenesis and Maintenance of Volume in Autogenous Bone Grafts. J Oral Maxillofac Surg 2018; 76:2097-2102. [DOI: 10.1016/j.joms.2018.06.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 06/14/2018] [Accepted: 06/14/2018] [Indexed: 01/07/2023]
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16
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Gessmann J, Seybold D, Ayami F, Peter E, Baecker H, Schildhauer TA, Köller M. Peripheral Blood Plasma Clot as a Local Antimicrobial Drug Delivery Matrix. Tissue Eng Part A 2018; 24:809-818. [DOI: 10.1089/ten.tea.2017.0319] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jan Gessmann
- Department of Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
- Department of Surgical Research, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Dominik Seybold
- Department of Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
- Department of Surgical Research, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Fahim Ayami
- Department of Surgical Research, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Elvira Peter
- Department of Surgical Research, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Hinnerk Baecker
- Department of Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Thomas Armin Schildhauer
- Department of Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Manfred Köller
- Department of Surgical Research, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
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17
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Comparative analysis of conventional and biological treatment in healing of bone disease. Saudi J Biol Sci 2018; 25:162-166. [PMID: 29379374 PMCID: PMC5775086 DOI: 10.1016/j.sjbs.2017.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 02/02/2017] [Accepted: 02/12/2017] [Indexed: 11/22/2022] Open
Abstract
The healing of Bone tissue consists of a complex process. Hence, we designed our study to evaluate chondrial diseases, which are as they have a very low healing capacity. Seventy two elderly osteoarthritis (OA) and 54-paediatric juvenile idiopathic arthritis (JIA) patients were included. The group was divided as 24 OA patients and 18 JIA patients in each group. Group I received Hyualuronic acid and glucocorticoides. Group II received platelet rich plasma and fibrin glue. Group III received PRP, fibrin glue, and MSC. 40 control patients received only PRP treatment. Out of 72 OA patients 35 (48.6%) male and 37 (51.4%) female with mean age of 48 ± 6.5 years. 64 (88.9%) Patients had pain and swelling. 52 (72.2%) lacked flexibility. 42 (58.3%) had hypertrophy. 28 (38.9%) had less cartilage thickness. 34 (47.2%) were in grade 3, grade 2 has 28 (38.9%) and grade 1 has 10 (13.9%) patients respectively. Among 54 JIA patients 28 (51.9%) male and 26 (48.1%) female patients with mean, age 4.6 ± 3.8 years. 39 (72.2%) had pain and swelling. 32 (59.3%) lacked flexibility. 29 (53.7%) children’s had functional disability. Group I patients showed 30% improvement with no statistical significance (P < 0.21). Group II showed 45% improvement with statistical significance (P < 0.01). In Group III 80%, improvement was observed with statistical significance (P < 0.001). In 40 control patients, 60% improvement was observed. In conclusion, use of these MSC, PRP, and PPP are safe and less cost effective for treating OA and JIA.
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Khanmohammadi M, Dastjerdi MB, Ai A, Ahmadi A, Godarzi A, Rahimi A, Ai J. Horseradish peroxidase-catalyzed hydrogelation for biomedical applications. Biomater Sci 2018; 6:1286-1298. [DOI: 10.1039/c8bm00056e] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Hydrogels catalyzed by horseradish peroxidase (HRP) serve as an efficient and effective platform for biomedical applications due to their mild reaction conditions for cells, fast and adjustable gelation rate in physiological conditions, and an abundance of substrates as water-soluble biocompatible polymers.
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Affiliation(s)
- Mehdi Khanmohammadi
- Department of Tissue Engineering and Applied Cell Sciences
- School of Advanced Technologies in Medicine
- Tehran University of Medical Sciences
- Tehran
- Iran
| | - Mahsa Borzouyan Dastjerdi
- Institute of Medical Biotechnology
- National Institute of Genetic Engineering and Biotechnology
- Tehran
- Iran
| | - Arman Ai
- School of Medicine
- Tehran University of Medical Sciences
- Tehran
- Iran
| | - Akbar Ahmadi
- Department of Neuroscience
- School of Advanced Technologies in Medicine
- Tehran University of Medical Sciences
- Iran
| | - Arash Godarzi
- Department of Tissue Engineering and Applied Cell Sciences
- School of Advanced Technologies in Medicine
- Tehran University of Medical Sciences
- Tehran
- Iran
| | - Azam Rahimi
- Department of Tissue Engineering and Applied Cell Sciences
- School of Advanced Technologies in Medicine
- Tehran University of Medical Sciences
- Tehran
- Iran
| | - Jafar Ai
- Department of Tissue Engineering and Applied Cell Sciences
- School of Advanced Technologies in Medicine
- Tehran University of Medical Sciences
- Tehran
- Iran
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Sodium-DNA for Bone Tissue Regeneration: An Experimental Study in Rat Calvaria. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7320953. [PMID: 29082254 PMCID: PMC5610838 DOI: 10.1155/2017/7320953] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 07/20/2017] [Indexed: 11/24/2022]
Abstract
Surgical techniques in dental and maxillofacial surgery request fast bone tissue regeneration, so there is a significant need to improve therapy for bone regeneration. Several studies have recently underlined the importance of nucleotides and nucleosides to increase cell proliferation and activity; in particular, the ability of polydeoxyribonucleotide (PDRN) to induce growth and activity of human osteoblasts was demonstrated. Sodium-DNA is the deoxyribonucleic acid (DNA) extracted from the gonadic tissue of male sturgeon and then purified, depolymerized, and neutralized with sodium hydroxide. To date, there are no evidences about the use of Sodium-DNA for bone tissue regeneration. Consequently, our question is about the efficacy of Sodium-DNA in bone healing. For testing the role of Sodium-DNA in bone healing we used a rat calvarial defect model. Sodium-DNA at different concentrations used alone or in association with Fibrin and/or Bio-Oss was used for healing treatments and the bone healing process was evaluated by histomorphometric and immunohistochemical analyses. Our results suggested a positive effect of Sodium-DNA in bone regeneration, providing a useful protocol and a model for the future clinical evaluation of its osteogenic properties.
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Noori A, Ashrafi SJ, Vaez-Ghaemi R, Hatamian-Zaremi A, Webster TJ. A review of fibrin and fibrin composites for bone tissue engineering. Int J Nanomedicine 2017; 12:4937-4961. [PMID: 28761338 PMCID: PMC5516781 DOI: 10.2147/ijn.s124671] [Citation(s) in RCA: 254] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Tissue engineering has emerged as a new treatment approach for bone repair and regeneration seeking to address limitations associated with current therapies, such as autologous bone grafting. While many bone tissue engineering approaches have traditionally focused on synthetic materials (such as polymers or hydrogels), there has been a lot of excitement surrounding the use of natural materials due to their biologically inspired properties. Fibrin is a natural scaffold formed following tissue injury that initiates hemostasis and provides the initial matrix useful for cell adhesion, migration, proliferation, and differentiation. Fibrin has captured the interest of bone tissue engineers due to its excellent biocompatibility, controllable biodegradability, and ability to deliver cells and biomolecules. Fibrin is particularly appealing because its precursors, fibrinogen, and thrombin, which can be derived from the patient's own blood, enable the fabrication of completely autologous scaffolds. In this article, we highlight the unique properties of fibrin as a scaffolding material to treat bone defects. Moreover, we emphasize its role in bone tissue engineering nanocomposites where approaches further emulate the natural nanostructured features of bone when using fibrin and other nanomaterials. We also review the preparation methods of fibrin glue and then discuss a wide range of fibrin applications in bone tissue engineering. These include the delivery of cells and/or biomolecules to a defect site, distributing cells, and/or growth factors throughout other pre-formed scaffolds and enhancing the physical as well as biological properties of other biomaterials. Thoughts on the future direction of fibrin research for bone tissue engineering are also presented. In the future, the development of fibrin precursors as recombinant proteins will solve problems associated with using multiple or single-donor fibrin glue, and the combination of nanomaterials that allow for the incorporation of biomolecules with fibrin will significantly improve the efficacy of fibrin for numerous bone tissue engineering applications.
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Affiliation(s)
- Alireza Noori
- Department of Tissue Engineering and Applied Cell Sciences, Faculty of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran
| | | | - Roza Vaez-Ghaemi
- Department of Chemical and Biological Engineering, Faculty of Biomedical Engineering, The University of British Columbia, Vancouver, BC, Canada
| | | | - Thomas J Webster
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
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21
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Elder BD, Witham TF. Fibrin Sealants, Platelet Gels, and Spinal Fusion. World Neurosurg 2016; 95:613. [DOI: 10.1016/j.wneu.2016.08.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 08/09/2016] [Indexed: 01/26/2023]
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22
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Liu Z, Zhu Y, Zhu H, He X, Liu X. Enhancement of posterolateral lumbar spine fusion using recombinant human bone morphogenetic protein-2 and mesenchymal stem cells delivered in fibrin glue. J Biomater Appl 2016; 31:477-487. [PMID: 27059496 DOI: 10.1177/0885328216643854] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mesenchymal stem cells have shown great potential for accelerating bone healing. In the present study, we evaluate the efficacy of fibrin glue/mesenchymal stem cells/recombinant human bone morphogenetic protein-2 composite for posterolateral spinal fusion in a rabbit model. Forty adult rabbits underwent posterolateral intertransverse fusion at the L5–L6 level. The animals were randomly divided into four groups based on the implant material: fibrin glue, fibrin glue/mesenchymal stem cells composite, fibrin glue-recombinant human bone morphogenetic protein-2 (fibrin glue/recombinant human bone morphogenetic protein-2) composite, and fibrin glue/mesenchymal stem cells/recombinant human bone morphogenetic protein-2 composite. After six weeks, the rabbits were euthanized for manual palpation, radiographic examination, biomechanical testing, and histology. Manual palpation results showed that the fusion rate for fibrin glue, fibrin glue/mesenchymal stem cells, fibrin glue/recombinant human bone morphogenetic protein-2, and fibrin glue/mesenchymal stem cells/recombinant human bone morphogenetic protein-2 was 0, 0, 40%, and 70%, respectively. Moreover, fusion rate determined by radiographic examination for fibrin glue, fibrin glue/mesenchymal stem cells, fibrin glue/recombinant human bone morphogenetic protein-2, and fibrin glue/mesenchymal stem cells/recombinant human bone morphogenetic protein-2 was 0, 0, 40%, and 80%, respectively. Gray analysis showed that fibrin glue/recombinant human bone morphogenetic protein-2 group had higher ossification area and density than fibrin glue group; and fibrin glue/mesenchymal stem cells/recombinant human bone morphogenetic protein-2 group had higher ossification area and density than fibrin glue/recombinant human bone morphogenetic protein-2 group. Formation of continuous bone masses between L5 and L6 level in mesenchymal stem cells/recombinant human bone morphogenetic protein-2/fibrin glue group was further confirmed by computed tomography scanning and three-dimensional reconstruction. Biomechanical testing demonstrated that the fusion strength (flexion, extension, lateral bending, and axial rotation) in fibrin glue/mesenchymal stem cells/recombinant human bone morphogenetic protein-2 group is significantly higher than that in fibrin glue/recombinant human bone morphogenetic protein-2 group. The formation of mature bone tissues between transverse processes of the fused specimens from both fibrin glue/recombinant human bone morphogenetic protein-2, and fibrin glue/mesenchymal stem cells/recombinant human bone morphogenetic protein-2 groups was confirmed by HE staining, and quantitative real-time polymerase chain reaction results showed the upregulation of CD31, type I collagen, osteocalcin, and osteonectin in the fibrin glue/mesenchymal stem cells/recombinant human bone morphogenetic protein-2 group. In conclusion, our findings show that mesenchymal stem cells delivered with recombinant human bone morphogenetic protein-2 using fibrin glue as carrier are more effective in enhancing spine fusion than recombinant human bone morphogenetic protein-2 without mesenchymal stem cells in the rabbit model.
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Affiliation(s)
- Zunpeng Liu
- Department of Orthopedics, First Affiliated Hospital, China Medical University, Shenyang, China
- Department of Orthopedics, Fourth Affiliated Hospital, China Medical University, Shenyang, China
| | - Yue Zhu
- Department of Orthopedics, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Haitao Zhu
- Department of Orthopedics, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Xiaoning He
- Department of Stomatology, Fourth Affiliated Hospital, China Medical University, Shenyang, China
| | - Xinchun Liu
- Department of Orthopedics, First Affiliated Hospital, China Medical University, Shenyang, China
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Vishnu Priya M, Sivshanmugam A, Boccaccini AR, Goudouri OM, Sun W, Hwang N, Deepthi S, Nair SV, Jayakumar R. Injectable osteogenic and angiogenic nanocomposite hydrogels for irregular bone defects. Biomed Mater 2016; 11:035017. [DOI: 10.1088/1748-6041/11/3/035017] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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24
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Dorozhkin SV. Calcium Orthophosphate-Containing Biocomposites and Hybrid Biomaterials for Biomedical Applications. J Funct Biomater 2015; 6:708-832. [PMID: 26262645 PMCID: PMC4598679 DOI: 10.3390/jfb6030708] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 07/31/2015] [Accepted: 08/01/2015] [Indexed: 12/30/2022] Open
Abstract
The state-of-the-art on calcium orthophosphate (CaPO4)-containing biocomposites and hybrid biomaterials suitable for biomedical applications is presented. Since these types of biomaterials offer many significant and exciting possibilities for hard tissue regeneration, this subject belongs to a rapidly expanding area of biomedical research. Through the successful combinations of the desired properties of matrix materials with those of fillers (in such systems, CaPO4 might play either role), innovative bone graft biomaterials can be designed. Various types of CaPO4-based biocomposites and hybrid biomaterials those are either already in use or being investigated for biomedical applications are extensively discussed. Many different formulations in terms of the material constituents, fabrication technologies, structural and bioactive properties, as well as both in vitro and in vivo characteristics have been already proposed. Among the others, the nano-structurally controlled biocomposites, those containing nanodimensional compounds, biomimetically fabricated formulations with collagen, chitin and/or gelatin, as well as various functionally graded structures seem to be the most promising candidates for clinical applications. The specific advantages of using CaPO4-based biocomposites and hybrid biomaterials in the selected applications are highlighted. As the way from a laboratory to a hospital is a long one and the prospective biomedical candidates have to meet many different necessities, the critical issues and scientific challenges that require further research and development are also examined.
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25
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Götz C, Warnke PH, Kolk A. Current and future options of regeneration methods and reconstructive surgery of the facial skeleton. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:315-23. [PMID: 26297391 DOI: 10.1016/j.oooo.2015.05.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 04/27/2015] [Accepted: 05/26/2015] [Indexed: 01/06/2023]
Abstract
Musculoskeletal defects attributable to trauma or infection or as a result of oncologic surgery present a common challenge in reconstructive maxillofacial surgery. The autologous vascularized bone graft still represents the gold standard for salvaging these situations. Preoperative virtual planning offers great potential and provides assistance in reconstructive surgery. Nevertheless, the applicability of autologous bone transfer might be limited within the medically compromised patient or because of the complexity of the defect and the required size of the graft to be harvested. The development of alternative methods are urgently needed in the field of regenerative medicine to enable the regeneration of the original tissue. Since the first demonstration of de novo bone formation by regenerative strategies and the application of bone growth factors some decades ago, further progress has been achieved by tissue engineering, gene transfer, and stem cell application concepts. This review summarizes recent approaches and current developments in regenerative medicine.
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Affiliation(s)
- Carolin Götz
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Patrick H Warnke
- Department of Oral and Maxillofacial Surgery, University of Kiel, Kiel, Germany; Belegärztliche Gemeinschaftspraxis für Oral-, Mund- und Kieferchirurgie und plastische Gesichtschirurgie Dres. Sprengel und Klebe, Flensburg, Germany
| | - Andreas Kolk
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
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Machado EG, Issa JPM, Figueiredo FATD, Santos GRD, Galdeano EA, Alves MC, Chacon EL, Ferreira Junior RS, Barraviera B, Cunha MRD. A new heterologous fibrin sealant as scaffold to recombinant human bone morphogenetic protein-2 (rhBMP-2) and natural latex proteins for the repair of tibial bone defects. Acta Histochem 2015; 117:288-96. [PMID: 25825118 DOI: 10.1016/j.acthis.2015.03.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 03/09/2015] [Accepted: 03/09/2015] [Indexed: 01/20/2023]
Abstract
Tissue engineering has special interest in bone tissue aiming at future medical applications Studies have focused on recombinant human bone morphogenetic protein-2 (rhBMP-2) and natural latex proteins due to the osteogenic properties of rhBMP-2 and the angiogenic characteristic of fraction 1 protein (P-1) extracted from the rubber tree Hevea brasiliensis. Furthermore, heterologous fibrin sealant (FS) has been shown as a promising alternative in regenerative therapies. The aim of this study was to evaluate these substances for the repair of bone defects in rats. A bone defect measuring 3mm in diameter was created in the proximal metaphysis of the left tibia of 60 rats and was implanted with rhBMP-2 or P-1 in combination with a new heterologous FS derived from snake venom. The animals were divided into six groups: control (unfilled bone defect), rhBMP-2 (defect filled with 5μg rhBMP-2), P-1 (defect filled with 5μg P-1), FS (defect filled with 8μg FS), FS/rhBMP-2 (defect filled with 8μg FS and 5μg rhBMP-2), FS/P-1 (defect filled with 8μg FS and 5μg P-1). The animals were sacrificed 2 and 6 weeks after surgery. The newly formed bone projected from the margins of the original bone and exhibited trabecular morphology and a disorganized arrangement of osteocyte lacunae. Immunohistochemical analysis showed intense expression of osteocalcin in all groups. Histometric analysis revealed a significant difference in all groups after 2 weeks (p<0.05), except for the rhBMP-2 and FS/rhBMP-2 groups (p>0.05). A statistically significant difference (p<0.05) was observed in all groups after 6 weeks in relation to the volume of newly formed bone in the surgical area. In conclusion, the new heterologous fibrin sealant was found to be biocompatible and the combination with rhBMP-2 showed the highest osteogenic and osteoconductive capacity for bone healing. These findings suggest a promising application of this combination in the regeneration surgery.
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27
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Gopi D, Shinyjoy E, Karthika A, Nithiya S, Kavitha L, Rajeswari D, Tang T. Single walled carbon nanotubes reinforced mineralized hydroxyapatite composite coatings on titanium for improved biocompatible implant applications. RSC Adv 2015. [DOI: 10.1039/c5ra04382d] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Carbon nanotubes reinforced mineralized hydroxyapatite (CNT/M-HAP) composite coating on titanium by pulsed electrodeposition is a promising approach to produce bioimplants with better osseointegration capacity and improved mechanical property.
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Affiliation(s)
- D. Gopi
- Department of Chemistry
- Periyar University
- Salem 636011
- India
- Centre for Nanoscience and Nanotechnology
| | - E. Shinyjoy
- Department of Chemistry
- Periyar University
- Salem 636011
- India
| | - A. Karthika
- Department of Chemistry
- Periyar University
- Salem 636011
- India
| | - S. Nithiya
- Department of Chemistry
- Periyar University
- Salem 636011
- India
| | - L. Kavitha
- Department of Physics
- School of Basic and Applied Sciences
- Central University of Tamilnadu
- Thiruvarur 610 101
- India
| | - D. Rajeswari
- Department of Chemistry
- Periyar University
- Salem 636011
- India
| | - Tingting Tang
- Shanghai Key Laboratory of Orthopaedic Implants
- Department of Orthopedic Surgery
- Shanghai Ninth People's Hospital
- Shanghai Jiaotong University School of Medicine
- Shanghai 20011
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28
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Schwartz-Arad D, Ofec R, Eliyahu G, Ruban A, Sterer N. Long Term Follow-Up of Dental Implants Placed in Autologous Onlay Bone Graft. Clin Implant Dent Relat Res 2014; 18:449-61. [DOI: 10.1111/cid.12288] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Devorah Schwartz-Arad
- Oral and Maxillofacial Surgery; Advanced Implantology, Periodontology & Endodontology; Schwartz-Arad Day-Care Surgical Center; Ramat Hasharon Israel
| | - Ronen Ofec
- Department of Statistics and Operations Research; Tel Aviv University; Tel Aviv Israel
| | - Galit Eliyahu
- Oral and Maxillofacial Surgery; Schwartz-Arad Day-Care Surgical Center; Ramat Hasharon Israel
| | - Angela Ruban
- Clinical Research Units; Schwartz-Arad Day-Care Surgical Center; Ramat Hasharon Israel
| | - Nir Sterer
- Clinical Research Units; Oral and Maxillofacial Surgery; Schwartz-Arad Day-Care Surgical Center; Ramat Hasharon Israel
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Topical vancomycin in combination with perioperative antibiotics and tight glycemic control helps to eliminate sternal wound infections. J Thorac Cardiovasc Surg 2014; 148:1035-8; 1038-40. [PMID: 25129595 DOI: 10.1016/j.jtcvs.2014.06.045] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 06/17/2014] [Accepted: 06/27/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study was undertaken to determine whether topical vancomycin would further reduce the incidence of sternal infections in the presence of perioperative antibiotics and tight glycemic control. METHODS A total of 1075 consecutive patients undergoing cardiac surgery from December 2007 to August 2013 receiving topical vancomycin (2.5 g in 2 mL of normal saline) applied as a slurry to the cut edges of the sternum were compared with 2190 patients from December 2003 to November 2007 who did not receive topical vancomycin. All patients received perioperative antibiotics (cefazolin 2 g intravenously every 8 hours and vancomycin 1 g intravenously every 12 hours) on induction of anesthetic and continuing for 48 hours; and intravenous insulin infusions to maintain serum blood glucose level between 120 and 180 mg/dL. RESULTS Patients receiving topical vancomycin had less superficial sternal infections (0% vs 1.6%; P < .0001), deep sternal infections (0% vs 0.7%; P = .005), any type of sternal infection (0% vs 2.2%; P < .0001) and significantly less sternal infections of any type in patients with diabetes mellitus (0% vs 3.3%; P = .0004). CONCLUSIONS Topical vancomycin applied to the sternal edges, in conjunction with perioperative antibiotics and tight glycemic control, helps to eliminate wound infections in cardiac surgical patients.
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Different angiogenic abilities of self-setting calcium phosphate cement scaffolds consisting of different proportions of fibrin glue. BIOMED RESEARCH INTERNATIONAL 2014; 2014:785146. [PMID: 25535615 PMCID: PMC4070487 DOI: 10.1155/2014/785146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 05/10/2014] [Indexed: 11/17/2022]
Abstract
To investigate the different angiogenic abilities of the self-setting calcium phosphate cement (CPC) consisting of different proportions of fibrin glue (FG), the CPC powder and the FG solution were mixed at the powder/liquid (P/L) ratios of 1 : 0.5, 1 : 1, and 1 : 2 (g/mL), respectively, and pure CPC was used as a control. After being implanted into the lumbar dorsal fascia of the rabbit, the angiogenic process was evaluated by histological examination and CD31 immunohistochemistry to detect the new blood vessels. The result of the new blood vessel showed that the P/L ratio of 1 : 1 group indicated the largest quantity of new blood vessel at 4 weeks, 8 weeks, and 12 weeks after implantation, respectively. The histological evaluation also showed the best vascular morphology in the 1 : 1 group at 4 weeks, 8 weeks, and 12 weeks after the operation, respectively. Our study indicated that the CPC-FG composite scaffold at the P/L ratio of 1 : 1 (g/mL) stimulated angiopoiesis better than any other P/L ratios and has significant potential as the bioactive material for the treatment of bone defects.
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Rajangam T, An SSA. Fibrinogen and fibrin based micro and nano scaffolds incorporated with drugs, proteins, cells and genes for therapeutic biomedical applications. Int J Nanomedicine 2013; 8:3641-62. [PMID: 24106425 PMCID: PMC3792008 DOI: 10.2147/ijn.s43945] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Over the past two decades, many types of natural and synthetic polymer-based micro- and nanocarriers, with exciting properties and applications, have been developed for application in various types of tissue regeneration, including bone, cartilage, nerve, blood vessels, and skin. The development of suitable polymers scaffold designs to aid the repair of specific cell types have created diverse and important potentials in tissue restoration. Fibrinogen (Fbg)- and fibrin (Fbn)-based micro- and nanostructures can provide suitable natural matrix environments. Since these primary materials are abundantly available in blood as the main coagulation proteins, they can easily interact with damaged tissues and cells through native biochemical interactions. Fbg- and Fbn-based micro and nanostructures can also be consecutively furnished/or encapsulated and specifically delivered, with multiple growth factors, proteins, and stem cells, in structures designed to aid in specific phases of the tissue regeneration process. The present review has been carried out to demonstrate the progress made with micro and nanoscaffold applications and features a number of applications of Fbg- and Fbn-based carriers in the field of biomaterials, including the delivery of drugs, active biomolecules, cells, and genes, that have been effectively used in tissue engineering and regenerative medicine.
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Affiliation(s)
- Thanavel Rajangam
- Department of Bionanotechnology, Gachon University, Seongnam-Si, Republic of Korea
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Dong J, Cui G, Bi L, Li J, Lei W. The mechanical and biological studies of calcium phosphate cement-fibrin glue for bone reconstruction of rabbit femoral defects. Int J Nanomedicine 2013; 8:1317-24. [PMID: 23576869 PMCID: PMC3617789 DOI: 10.2147/ijn.s42862] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In order to improve the mechanical and biological properties of calcium phosphate cement (CPC, nanometer-biomaterial) for bone reconstruction in the rabbit femoral defect model, fibrin glue (FG, the natural product, purified from the blood) was introduced at three different ratios. The CPC powder and the FG solution were mixed, respectively, at the powder/liquid (P/L) ratios (g/mL) of 1:1, 3:1, and 5:1 (g/mL), and pure CPC was used as a control. After being implanted into the femoral defect in rabbit, the healing process was evaluated by micro-computed tomography scan, biomechanical testing, and histological examination. By micro-computed tomography analysis, the P/L ratio of 1:1 (g/mL) group indicated the largest quantity of new bone formation at 4 weeks, 8 weeks, and 12 weeks after implantation, respectively. Bone volume per trabecular volume of the 1:1 group was highest in the four groups, which was 1.45% ± 0.42%, 7.35% ± 1.45%, and 29.10% ± 1.67% at 4 weeks, 8 weeks, and 12 weeks after the operation, respectively. In the biomechanical tests, the compressive strength and the elastic modulus of the three CPC–FG groups were much higher than those of the pure CPC group at the determined time point (P < 0.05). The histological evaluation also showed the best osseointegration in the 1:1 group at 4 weeks, 8 weeks, and 12 weeks after the operation, respectively. In the 1:1 group, the bone grew into the pore of the cement in the laminar arrangement and connected with the cement tightly at the 12th week after the operation. This present study indicated that the CPC–FG composite at the P/L ratio of 1:1 (g/mL) stimulated bone regeneration better than any other designed group, which suggested that CPC–FG at the P/L ratio of 1:1 has significant potential as the bioactive material for the treatment of bone defects.
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Affiliation(s)
- Jingjing Dong
- Institute of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
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Becerra-Bayona S, Guiza-Arguello V, Qu X, Munoz-Pinto DJ, Hahn MS. Influence of select extracellular matrix proteins on mesenchymal stem cell osteogenic commitment in three-dimensional contexts. Acta Biomater 2012; 8:4397-404. [PMID: 22871641 DOI: 10.1016/j.actbio.2012.07.048] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Revised: 06/20/2012] [Accepted: 07/31/2012] [Indexed: 12/31/2022]
Abstract
Growth factors have been shown to be powerful mediators of mesenchymal stem cell (MSC) osteogenic differentiation. However, their use in tissue engineered scaffolds not only can be costly but also can induce undesired responses in surrounding tissues. Thus, the ability to specifically promote MSC osteogenic differentiation in the absence of exogenous growth factors via the manipulation of scaffold material properties would be beneficial. The current work examines the influence of select extracellular matrix (ECM) proteins on MSC osteogenesis toward the goal of developing scaffolds with intrinsically osteoinductive properties. Fibrinogen (FG), fibronectin (FN) and laminin-1 (LN) were chosen for evaluation due to their known roles in bone morphogenesis or bone fracture healing. These proteins were conjugated into poly(ethylene glycol) diacrylate (PEGDA) hydrogels and their effects on encapsulated 10T½ MSCs were evaluated. Specifically, following 1week of culture, mid-term markers of various MSC lineages were examined in order to assess the strength and specificity of the observed osteogenic responses. PEG-LN gels demonstrated increased levels of the osteogenic transcription factor osterix relative to day 0 levels. In addition, PEG-FG and PEG-LN gels were associated with increased deposition of bone ECM protein osteocalcin relative to PEG-FN gels and day 0. Importantly, the osteogenic response associated with FG and LN appeared to be specific in that markers for chondrocytic, smooth muscle cell and adipocytic lineages were not similarly elevated relative to day 0 in these gels. To gain insight into the integrin dynamics underlying the observed differentiation results, initial integrin adhesion and temporal alterations in cell integrin profiles were evaluated. The associated results suggest that α(2), α(v) and α(6) integrin subunits may play key roles in integrin-mediated osteogenesis.
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Han Y, Zeng Q, E L, Wang D, He H, Liu H. Sustained Topical Delivery of Insulin From Fibrin Gel Loaded With Poly(Lactic-Co-Glycolic Acid) Microspheres Improves the Biomechanical Retention of Titanium Implants in Type 1 Diabetic Rats. J Oral Maxillofac Surg 2012; 70:2299-308. [DOI: 10.1016/j.joms.2012.05.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 05/09/2012] [Accepted: 05/27/2012] [Indexed: 11/24/2022]
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Miron RJ, Zhang YF. Osteoinduction: a review of old concepts with new standards. J Dent Res 2012; 91:736-44. [PMID: 22318372 DOI: 10.1177/0022034511435260] [Citation(s) in RCA: 208] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Since the discovery of osteoinduction in the early 20th century, innovative biomaterials with osteoinductive potential have emerged. Over the last 50 years, however, our ability to describe biological phenomena accurately has been improved dramatically by advancements in cell and molecular biology. The aim of this review is to divide the osteoinduction phenomenon into 3 principles: (1) mesenchymal cell recruitment, (2) mesenchymal differentiation to bone-forming osteoblasts, and (3) ectopic bone formation in vivo. Furthermore, this review formulates guidelines for in vitro and in vivo experimental testing for accurately defining new biomaterials as osteoinductive. The use of growth factors with osteoinductive potential in periodontal and oral surgery is discussed. These concepts and guidelines aim to guide the future direction of emerging biomaterials in bone regeneration.
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Affiliation(s)
- R J Miron
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine, Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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Przybylowski C, Quinn T, Callahan A, Kaplan M, Golding A, Alesi C, Ammar M, LeBlon CE, Guo Y, Zhang X, Jedlicka SS. MC3T3 preosteoblast differentiation on bone morphogenetic protein-2 peptide ormosils. ACTA ACUST UNITED AC 2012. [DOI: 10.1039/c2jm16490f] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Willers C, Wood DJ, Zheng MH. A CURRENT REVIEW ON THE BIOLOGY AND TREATMENT OF ARTICULAR CARTILAGE DEFECTS (PART I & PART II). ACTA ACUST UNITED AC 2011. [DOI: 10.1142/s0218957703001125] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Osteochondral injury occurs predominantly in physically active young adult males. Injury to the articular cartilage and/or subchondral bone may not only cause acute joint disease resulting in osseous intracapsular (synovitis) or extracapsular pain, but may also act to spawn arthritic conditions in later life. Since the 18th century, such injury has proven difficult to treat clinically, and much therapy has been essentially palliative. Past treatments such as abrasion arthroplasty, drilling, microfracture and arthroscopic lavage have been useful in removing articular debris and promoting the formation of the fibrin clot used in most native repair mechanisms. However, the limitation of these techniques is their inability to restore the damaged cartilage and subchondral bone to their normal tissue architecture. Recent developments in tissue engineering have concentrated on the utilization of autologous chondrocyte implantation, biomaterials and growth factors to promote the regeneration of biomechanically superior hyaline articular cartilage. This paper reviews the etiology, repair biology and therapeutic techniques of cartilage and/or osteochondral injury over the previous decades, and attempts to provide insight into interesting new research directions which offer much potential for improved treatment of these troublesome lesions.
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Affiliation(s)
- Craig Willers
- Department of Orthopaedic Surgery, School of Surgery and Pathology, University of Western Australia, Nedlands, 6009, W.A., Australia
| | - David J. Wood
- Department of Orthopaedic Surgery, School of Surgery and Pathology, University of Western Australia, Nedlands, 6009, W.A., Australia
| | - Ming H. Zheng
- Department of Orthopaedic Surgery, School of Surgery and Pathology, University of Western Australia, Nedlands, 6009, W.A., Australia
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Abstract
The state-of-the-art of biocomposites and hybrid biomaterials based on calcium orthophosphates that are suitable for biomedical applications is presented in this review. Since these types of biomaterials offer many significant and exciting possibilities for hard tissue regeneration, this subject belongs to a rapidly expanding area of biomedical research. Through successful combinations of the desired properties of matrix materials with those of fillers (in such systems, calcium orthophosphates might play either role), innovative bone graft biomaterials can be designed. Various types of biocomposites and hybrid biomaterials based on calcium orthophosphates, either those already in use or being investigated for biomedical applications, are extensively discussed. Many different formulations, in terms of the material constituents, fabrication technologies, structural and bioactive properties as well as both in vitro and in vivo characteristics, have already been proposed. Among the others, the nanostructurally controlled biocomposites, those containing nanodimensional compounds, biomimetically fabricated formulations with collagen, chitin and/or gelatin as well as various functionally graded structures seem to be the most promising candidates for clinical applications. The specific advantages of using biocomposites and hybrid biomaterials based on calcium orthophosphates in the selected applications are highlighted. As the way from the laboratory to the hospital is a long one, and the prospective biomedical candidates have to meet many different necessities, this review also examines the critical issues and scientific challenges that require further research and development.
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Yilmaz S, Kabadayi C, Ipci SD, Cakar G, Kuru B. Treatment of intrabony periodontal defects with platelet-rich plasma versus platelet-poor plasma combined with a bovine-derived xenograft: a controlled clinical trial. J Periodontol 2010; 82:837-44. [PMID: 21138357 DOI: 10.1902/jop.2010.100503] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of this study is to assess the healing outcomes of intrabony defects after treatment with platelet-rich plasma (PRP) versus platelet-poor plasma (PPP) combined with bovine-derived xenograft (BDX). METHODS Using a split-mouth design, a total of 79 intrabony defects with an intrabony component of ≥3 mm in 20 patients were treated either with PRP/BDX (group 1) or PPP/BDX (group 2). At baseline and 12 months after surgery, plaque and sulcus bleeding indices, probing depth (PD), relative attachment level, recession, and probing and radiographic bone levels were recorded. RESULTS After 12 months, groups 1 and 2 presented a mean PD reduction of 3.87 ± 0.86 and 3.76 ± 0.80 mm, recession of 1.35 ± 0.68 and 1.58 ± 0.54 mm, attachment gain of 2.51 ± 0.97 and 2.18 ± 0.87 mm, clinical bone gain of 2.18 ± 0.86 and 2.09 ± 0.89 mm, and radiographic bone gain of 2.11 ± 0.87 and 2.19 ± 0.96 mm, respectively. Intergroup differences were found to be insignificant. CONCLUSIONS Within its limits, these results suggest that the outcomes of the treatment after PRP/BDX and PPP/BDX applications in intrabony defects are similar. When the platelet counts are taken into consideration, PPP seems to demonstrate similar clinical efficacy as the PRP.
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Affiliation(s)
- Selcuk Yilmaz
- Department of Periodontology, Dental Faculty, Yeditepe University, Istanbul, Turkey.
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Goyenvalle E, Aguado E, Pilet P, Daculsi G. Biofunctionality of MBCP ceramic granules (TricOs) plus fibrin sealant (Tisseel) versus MBCP ceramic granules as a filler of large periprosthetic bone defects: an investigative ovine study. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2010; 21:1949-1958. [PMID: 20238148 DOI: 10.1007/s10856-010-4043-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Accepted: 03/01/2010] [Indexed: 05/28/2023]
Abstract
We aimed to quantify bone colonization toward an untreated titanium implant with primary stability following filling of the defect with micromacroporous biphasic calcium phosphate (MBCP) granules (TricOs) or MBCP granules mixed with fibrin sealant (Tisseel). Medial arthrotomy was performed on the knees of 20 sheep to create a bone defect (16 mm deep; 10 mm diameter), followed by anchorage of a titanium screw. Defects were filled with TricOs or TricOs-Tisseel granules, a perforated MBCP washer, a titanium washer and titanium screw. Sheep were euthanized at 3, 6, 12 and 26 weeks. From Week 12 onwards, the percentage of bone in contact with the 8 mm anchorage part of the screw increased in both groups, confirming its primary stability. At 26 weeks, whereas bone colonization was similar in both groups, biodegradation of ceramic was more rapid in the TricOs-Tisseel group (P = 0.0422). The centripetal nature of bone colonization was evident. Bone contact with the titanium implant surface was negligible. In conclusion, the use of a model that reproduces a large metaphyseal bone defect around a titanium implant with primary stability, filled with a mixture of either TricOs ceramic granules or TricOs granules mixed with Tisseel fibrin sealant, suggests that the addition of fibrin to TricOs enhances bone filling surgical technology.
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Affiliation(s)
- E Goyenvalle
- UPSP BBToCex, Ecole Nationale Vétérinaire de Nantes, BP 40706, 44307 Nantes Cedex 3, France.
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Nair MB, Varma HK, John A. Platelet-rich plasma and fibrin glue-coated bioactive ceramics enhance growth and differentiation of goat bone marrow-derived stem cells. Tissue Eng Part A 2009; 15:1619-31. [PMID: 19072085 DOI: 10.1089/ten.tea.2008.0229] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
New biotechnologies such as tissue engineering require functionally active cells within supportive matrices where the physical and chemical stimulus provided by the matrix is indispensable to determine the cellular behavior. This study has investigated the influence of platelet-rich plasma (PRP) and fibrin glue (FG) on the functional activity of goat bone marrow-derived mesenchymal stem cells (gBMSCs) that differentiated into the osteogenic lineage. To achieve this goal, PRP and FG were separately coated on bioactive ceramics like hydroxyapatite (HA) and silica-coated HA (HASi), on which gBMSCs were seeded and induced to differentiate into the osteogenic lineage for 28 days. The cells were then analyzed for viability (lactate dehydrogenase assay: acridine orange and ethidium bromide staining), morphology (scanning electron microscopy), proliferation (picogreen assay), cell cycle assay (propidium iodide staining), and differentiation (alkaline phosphatase [ALP] activity and real-time PCR analysis of ALP, osteocalcin, and osteopontin gene). It has been observed that PRP and FG have appreciably favored the viability, spreading, and proliferation of osteogenic-induced gBMSCs. The osteopontin and osteocalcin expression was significantly enhanced on PRP- and FG-coated HA and HASi, but PRP had effect on neither ALP expression nor ALP activity. The results of this study have depicted that FG-coated ceramics were better than PRP-coated and bare matrices. Among all, the excellent performance was shown by FG coated HASi, which may be attributed to the communal action of the stimulus emanated by Si in HASi and the temporary extracellular matrix provided by FG over HASi. Thus, we can conclude that PRP or FG in combination with bioactive ceramics could possibly enhance the functional activity of cells to a greater extent, promoting the hybrid composite as a promising candidate for bone tissue engineering applications.
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Affiliation(s)
- Manitha B Nair
- Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India
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Torigoe I, Sotome S, Tsuchiya A, Yoshii T, Maehara H, Sugata Y, Ichinose S, Shinomiya K, Okawa A. Bone Regeneration with Autologous Plasma, Bone Marrow Stromal Cells, and Porous β-Tricalcium Phosphate in Nonhuman Primates. Tissue Eng Part A 2009; 15:1489-99. [DOI: 10.1089/ten.tea.2008.0317] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ichiro Torigoe
- Section of Orthopaedic and Spinal Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shinichi Sotome
- Section of Orthopaedic and Spinal Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
- Section of Regenerative Therapeutics for Spine and Spinal Cord, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akio Tsuchiya
- Section of Orthopaedic and Spinal Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshitaka Yoshii
- Section of Orthopaedic and Spinal Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hidetsugu Maehara
- Section of Orthopaedic and Spinal Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yumi Sugata
- Section of Orthopaedic and Spinal Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
- Global Center of Excellence (GCOE) Program; International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shizuko Ichinose
- Instrumental Analysis Research Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenichi Shinomiya
- Section of Orthopaedic and Spinal Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
- Global Center of Excellence (GCOE) Program; International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University, Tokyo, Japan
- Hard Tissue Genome Research Center, Tokyo Medical and Dental University, Tokyo, Japan
- Core to Core Program for Advanced Bone and Joint Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsushi Okawa
- Section of Orthopaedic and Spinal Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
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Effect of platelet-rich plasma and fibrin glue on healing of critical-size calvarial bone defects. J Craniofac Surg 2009; 20:34-40. [PMID: 19164985 DOI: 10.1097/scs.0b013e318190ddb9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Despite the insufficient number of experimental studies, platelet-rich plasma (PRP) including high amounts of growth factors is introduced to clinical use rapidly. The aim of this study was to compare the effects of PRP and platelet-poor plasma (PPP) on healing of critical-size bone defects.Bilateral full-thickness, critical-size bone defects were created in the parietal bones of 32 rabbits, which had been studied in 4 groups. Saline, thrombin solution, PPP, and PRP were applied to the created defects before closure. Radiologic defect area measurement results at 0, 4, and 16 weeks were compared between the groups. In addition, densities of the newly formed bones at 16th week were studied. Histologic parameters (primary and secondary bone trabecula, neovascularization, and bone marrow and connective tissue formation) were compared between 4- and 16-week groups.More rapid decrease in defect size was observed in groups 3 and 4 than in groups 1 and 2, both in the 4th and 16th weeks. Newly formed bone densities were also found to be higher in these 2 groups. New bone formation was detected to be more rapid considering histologic parameters, in groups 3 and 4 at 4th and 16th weeks.Study demonstrates that PRP and PPP might have favorable effects on bone healing. Although we cannot reveal any statistical difference between these 2 substances considering osteoinductive potential, PRP group has demonstrated superior results compared with fibrin glue group. Higher platelet concentrations may expose beneficial effects of PRP.
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Hou T, Xu J, Li Q, Feng J, Zen L. In vitro evaluation of a fibrin gel antibiotic delivery system containing mesenchymal stem cells and vancomycin alginate beads for treating bone infections and facilitating bone formation. Tissue Eng Part A 2008; 14:1173-82. [PMID: 18593356 DOI: 10.1089/ten.tea.2007.0159] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Bone infection and defects are two major problems that occur in the course of treating posttraumatic open bone fractures and osteomyelitis for which local antibiotic delivery is efficacious. Further, hemostasis is an essential treatment after removal of infected bones. Herein we report a new antibiotics delivery system made of vancomycin alginate beads embedded in a fibrin gel (Vanco-AB-FG) to treat bone infections, with the addition of bone marrow-derived mesenchymal stem cells (BMMSCs) seeded in the fibrin gel to promote bone formation. The proliferation of BMMSCs was measured under different conditions of three-dimensional (3D) gel or monolayer, with or without Vanco-AB; cells were labeled by enhanced green fluorescence protein, and their morphology and distribution were observed. The alkaline phosphatase (ALP) activity, real-time RT-PCR, and von Kossa staining were used for determining the osteogenic differentiation of BMMSCs. The concentrations of vancomycin resulting from the antibiotic delivery were determined; the antibiotic activity was evaluated by an assay with standard Staphylococcus aureus (ATCC 25923) as a biological target. The results showed that for Vanco-AB-FG, vancomycin concentrations remained above the breakpoint sensitivity for 22 days. The 3D culture within the gel and the addition of Vanco-AB affected the cell behavior. The morphology of BMMSCs within the 3D gel was different from that in monolayer. The proliferation of the cells within the 3D gel was lower than that in monolayer in early stage, but in later stage the number of BMMSCs in Vanco-AB-FG was similar to that in monolayer. The ALP activity was higher in the 3D gel, and the addition of Vanco-AB slightly increased ALP activity. The osteogenic gene expression levels of ALP, osteopontin, and alpha1 chain of collagen I were higher in the 3D gel than those in monolayer, and additional Vanco-AB could also increase their expression. The von Kossa staining showed that the deposition of mineralization was observed in both the 3D gel and monolayer cultures, but the mineralization nodule size in monolayer was bigger and the number of them in 3D gel was greater. In conclusion, this system could be an alternative treatment for bone infections and defects.
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Affiliation(s)
- Tianyong Hou
- Department of Orthopaedics, Southwest Hospital, Chongqing, China
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Tuusa SMR, Lassila LVJ, Matinlinna JP, Peltola MJ, Vallittu PK. Initial adhesion of glass-fiber-reinforced composite to the surface of porcine calvarial bone. J Biomed Mater Res B Appl Biomater 2008; 75:334-42. [PMID: 16032653 DOI: 10.1002/jbm.b.30311] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of this preliminary study was to compare the initial bond strength of the glass-fiber-reinforced composite veil to the surface of the porcine calvarial compact bone using different adhesives. Fiber-reinforced composite (FRC) made of E-glass fiber veil with the BisGMA-PMMA resin system was used in the study. For the shear bond strength test, porcine calvarial bone cubes were mounted into resin matrix. FRC-veil discs were bonded to compact bone with different types of adhesives: (A) BisGMA-HEMA based (3M-ESPE Scotchbond Multi-Purpose Adhesive), (B) 4-META/UDMA/BisGMA based (Unifil Bond Bonding Agent) and MDP based (Clearfil Se Bond adhesive), (C) UDMA/BisGMA/PMMA-based experimental adhesive, and (D) silane-based (APS, ICS, MPS) experimental adhesives. The surface of the bone was mechanically roughened and was either used as such, treated with dental primers (Unifil Bond Self-etching Primer, Clearfil Se Bond Primer), or treated with an experimental silane mixture (APS, ICS, MPS), or with a mixture of the experimental silane liquid and Clearfil Se Bond Primer. The 3M-ESPE Scotchbond Multi-Purpose Adhesive and UDMA/BisGMA/PMMA experimental adhesive gave poor results in the shear bond test (0.58 and 0.40 MPa, respectively). Unifil Bond Bonding Agent and Clearfil Se Bond adhesive with respective primers markedly improved the shear bond strength; with Unifil the result was 3.40 MPa, and with Clearfil it was 6.19 MPa. When the bone surface was primed with a mixture of Clearfil Se Bond Primer and Clearfil Porcelain Bond Activator, the Clearfil Se Bond adhesive-impregnated FRC veil gave the best adhesion to the bone surface in this test: 9.50 MPa. The addition of bioactive glass granules between the veil and the bone lowered the shear bond strength in the test system described above to 6.72 MPa. The test systems with the silane mixture were also promising. In the SEM study, it was found that the mechanical treatment reveals the pores of the bone surface. Chemical treatments of the bone surface improved the adhesion of the FRC veil to the bone. The results showed that the adhesion of the FRC to the surface of the bone can be significantly improved with mechanical roughening and with special chemical treatments of the bone surface.
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Affiliation(s)
- S M R Tuusa
- Department of Prosthetic Dentistry and Biomaterials Research, Institute of Dentistry, University of Turku, Turku, Finland.
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Hydroxyapatite-bioactive glass ceramic composite as stand-alone graft substitute for posterolateral fusion of lumbar spine: a prospective, matched, and controlled study. ACTA ACUST UNITED AC 2008; 21:106-11. [PMID: 18391714 DOI: 10.1097/bsd.0b013e31805fea1f] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
STUDY DESIGN Prospective, matched, and controlled study. OBJECTIVE To evaluate the efficacy of hydroxyapatite-bioactive glass ceramic composite (Chitra-HABg) as a stand-alone graft substitute in promoting posterolateral fusion in the lumbar spine as compared with autologous bone. BACKGROUND The use of ceramics as stand-alone graft substitutes in posterolateral fusion remains controversial. The Chitra-HABg is a new composite that has undergone clinical trials in various orthopedic applications with excellent clinical and radiologic outcomes. METHODS Twenty-four patients underwent instrumented posterolateral fusion, with Chitra-HABg laid on the left intertransverse bed and autogenous graft on the right side. The primary outcome measure was radiologic consolidation of the graft, and secondary outcome measures were the work status and the Modified Oswestry Disability index. The McNamara and Student chi test were applied for statistical analysis. RESULTS Although the study was prematurely terminated owing to the high incidence of resorption of Chitra-HABg, 22 of the 24 subjects were followed-up for a minimum of 1 year. At the end of 1-year, excellent radiologic outcome was seen on the right side (autogenous graft) in all the cases, whereas 95% (21/22) of the cases had poor consolidation on the left side (Chitra-HABg). The clinical outcome was rated as good in 16/22 (73%) patients, fair in 5, and poor in only 1 patient, but this had no statistically significant association with the consolidation of the fusion mass. CONCLUSIONS This study clearly demonstrates that hydroxyapatite-bioactive glass ceramic composites (Chitra-HABg) has no role as stand-alone bone graft substitutes in posterolateral fusion of the lumbar spine, as the composite undergoes resorption without the formation of bridging callus. LEVEL OF EVIDENCE Level 1.
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Sastry TP, Sundaraseelan J, Swarnalatha K, Liji Sobhana SS, Uma Makheswari M, Sekar S, Mandal AB. Growth of hydroxyapatite on physiologically clotted fibrin capped gold nanoparticles. NANOTECHNOLOGY 2008; 19:245604. [PMID: 21825816 DOI: 10.1088/0957-4484/19/24/245604] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The growth of hydroxyapatite (HAp) on physiologically clotted fibrin (PCF)-gold nanoparticles is presented for the first time by employing a wet precipitation method. Fourier transform infrared (FTIR) spectroscopy confirmed the characteristic functionalities of PCF and HAp in the PCF-Au-HAp nanocomposite. Scanning electron microscopy (SEM) images have shown cuboidal nanostructures having a size in the range of 70-300 nm of HAp, whereas 2-50 nm sized particles were visualized in high-resolution transmission electron microscopy (TEM). Energy-dispersive x-ray (EDX) and x-ray diffraction (XRD) studies have confirmed the presence of HAp. These results show that gold nanoparticles with PCF acted as a matrix for the growth of HAp, and that PCF-Au-HAp nanocomposite is expected to have better osteoinductive properties.
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Endres K, Marx R, Tinschert J, Wirtz DC, Stoll C, Riediger D, Smeets R. A new adhesive technique for internal fixation in midfacial surgery. Biomed Eng Online 2008; 7:16. [PMID: 18489785 PMCID: PMC2430571 DOI: 10.1186/1475-925x-7-16] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2007] [Accepted: 05/19/2008] [Indexed: 12/02/2022] Open
Abstract
Background The current surgical therapy of midfacial fractures involves internal fixation in which bone fragments are fixed in their anatomical positions with osteosynthesis plates and corresponding screws until bone healing is complete. This often causes new fractures to fragile bones while drilling pilot holes or trying to insert screws. The adhesive fixation of osteosynthesis plates using PMMA bone cement could offer a viable alternative for fixing the plates without screws. In order to achieve the adhesive bonding of bone cement to cortical bone in the viscerocranium, an amphiphilic bone bonding agent was created, analogous to the dentin bonding agents currently on the market. Methods The adhesive bonding strengths were measured using tension tests. For this, metal plates with 2.0 mm diameter screw holes were cemented with PMMA bone cement to cortical bovine bone samples from the femur diaphysis. The bone was conditioned with an amphiphilic bone bonding agent prior to cementing. The samples were stored for 1 to 42 days at 37 degrees C, either moist or completely submerged in an isotonic NaCl-solution, and then subjected to the tension tests. Results Without the bone bonding agent, the bonding strength was close to zero (0.2 MPa). Primary stability with bone bonding agent is considered to be at ca. 8 MPa. Moist storage over 42 days resulted in decreased adhesion forces of ca. 6 MPa. Wet storage resulted in relatively constant bonding strengths of ca. 8 MPa. Conclusion A new amphiphilic bone bonding agent was developed, which builds an optimizied interlayer between the hydrophilic bone surface and the hydrophobic PMMA bone cement and thus leads to adhesive bonding between them. Our in vitro investigations demonstrated the adhesive bonding of PMMA bone cement to cortical bone, which was also stable against hydrolysis. The newly developed adhesive fixing technique could be applied clinically when the fixation of osteosynthesis plates with screws is impossible. With the detected adhesion forces of ca. 6 to 8 MPa, it is assumed that the adhesive fixation system is able to secure bone fragments from the non-load bearing midfacial regions in their orthotopic positions until fracture consolidation is complete.
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Affiliation(s)
- Kira Endres
- University Hospital Aachen, Dental Prosthetics Clinic, Medical Materials R&D Laboratory, Pauwelsstrasse 30, 52057 Aachen, Germany.
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Le Nihouannen D, Saffarzadeh A, Gauthier O, Moreau F, Pilet P, Spaethe R, Layrolle P, Daculsi G. Bone tissue formation in sheep muscles induced by a biphasic calcium phosphate ceramic and fibrin glue composite. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2008; 19:667-75. [PMID: 17619955 DOI: 10.1007/s10856-007-3206-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2006] [Accepted: 07/25/2006] [Indexed: 05/16/2023]
Abstract
Some biomaterials are able to induce ectopic bone formation in muscles of large animals. The osteoinductive potential of macro- micro-porous biphasic calcium phosphate (MBCP) ceramic granules with fibrin glue was evaluated by intramuscular implantation for 6 months in six adult female sheep. The MBCP granules were 1-2 mm in size and were composed of hydroxyapatite (HA) and beta-tricalcium phosphate (beta-TCP) in a 60/40 ratio. The fibrin glue was composed of fibrinogen, thrombin and other biological factors. After 6 months of implantation in the dorsal muscles of sheep, the explants were rigid. Histology, back-scattered electron microscopy and micro-computed tomography of the implants indicated that approximately 12% of mineralized bone had formed in between the MBCP granules. The ectopic bone appeared well-mineralized with mature osteocytes and Haversian structures. In addition, the number and thickness of bone trabeculae formed in between the MBCP particles were similar to those measured in trabecular bone in sheep. The overall results therefore confirmed the formation of well-mineralized ectopic bone tissue after intramuscular implantation of MBCP/fibrin glue composites. These bone substitutes exhibiting osteoinductive properties could be used for the reconstruction of large bone defects.
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Affiliation(s)
- Damien Le Nihouannen
- INSERM U791, Laboratoire d'ingénierie ostéoarticulaire et dentaire, Univ. Nantes, Faculté de chirurgie dentaire, 1 place Alexis Ricordeau, Nantes, France
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TricOs TM and Fibrin Sealant Combined for Bone Defect Filling: from Pre-Clinical Tests to Prospective Clinical Study. Preliminary Human Data. ACTA ACUST UNITED AC 2007. [DOI: 10.4028/www.scientific.net/kem.361-363.1335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The association of TricOsTM (Macroporous Biphasic Ceramic Phosphate MBCP
granules) and the fibrin sealant FS VH S/D 4, has been developed to answer a challenging request
of orthopaedic surgeons: a biocompatible, osteogenic, mouldable, and self-hardening bone
substitute able to fill randomly shaped bone defects. The aims of this study was the evaluation of
the performance and safety of the bioactive bone substitute TricOs™ associated with a fibrin
sealant in regeneration of functional bone. The pre-clinical tests were conducted to optimize MBCP
granules size and ratio MBCP–FS VH S/D 4 (sheep maxillary sinus grafting, femoral epiphysis
defect in rabbits, long bone defects in sheep). A clinical study design was set up as an exploratory
prospective French multicentric phase II study sponsored by INSERM (Institut National de la Santé
et de la Recherche Médicale). The application was the TOV (Tibial Osteotomy of Valgisation)
using osteosynthesis and bone substitute: TricOs™ mixed with the fibrin sealant (FS VH S/D 4) for
filling the space created. The follow up is 13 months with safety checks, clinical assessments, highsensitivity
X-ray, and CT-scan imaging. A bone sample will be collected from the reconstructed
area at 12 months, during the osteosynthesis material removal surgery. The principal criterion is
CT-scan imaging performed 12 months after TOV surgery, before material removal, to assess
qualitative and quantitative bone reconstruction. Animals’ studies demonstrate that the biomaterial
is safe to use and shows osteoconductive properties, granules resorption and bone ingrowth at the
expenses of the implants. As for clinical trial, 7 patients are today included in the study: This paper
present the first results obtained from X-ray imaging during follow up.
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