Interaction of Folic Acid with Nanocrystalline Apatites and Extension to Methotrexate (Antifolate) in View of Anticancer Applications

Nanocrystalline apatites mimicking bone mineral represent a versatile platform for biomedical applications thanks to their similarity to bone apatite and the possibility to (multi)functionalize them so as to provide "à la carte" properties. One relevant domain is in particular oncology, where drug-loaded biomaterials and engineered nanosystems may be used for diagnosis, therapy, or both. In a previous contribution, we investigated the adsorption of doxorubicin onto two nanocrystalline apatite substrates, denoted HA and FeHA (superparamagnetic apatite doped with iron ions), and explored these drug-loaded systems against tumor cells. To widen their applicability in the oncology field, here we examine the interaction between the same two substrates and two other molecules: folic acid (FA), often used as cell targeting agent, and the anticancer drug methotrexate (MTX), an antifolate analogue. In a first stage, we investigated the adsorptive behavior of FA (or MTX) on both substrates, evidencing their specificities. At low concentration, typically under 100 mmol/L, adsorption onto HA was best described using the Sips isotherm model, while the formation of a calcium folate secondary salt was evidenced at high concentration by Raman spectroscopy. Adsorption onto FeHA was instead fitted to the Langmuir model. A larger adsorptive affinity was found for the FeHA substrate compared to HA; accordingly, a faster release was noticed from HA. In vitro tests carried out on human osteosarcoma cell line (SAOS-2) allowed us to evaluate the potential of these compounds in oncology. Finally, in vivo (subcutaneous) implantations in the mouse were run to ascertain the biocompatibility of the two substrates. These results should allow a better understanding of the interactions between FA/MTX and bioinspired nanocrystalline apatites in view of applications in the field of cancer.

Effects on growth and osteogenic differentiation of mesenchymal stem cells by the strontium-added sol-gel hydroxyapatite gel materials

In the present study, strontium-modified hydroxyapatite gels (Sr-HA) at different concentrations were prepared using sol-gel approach and their effect on human-bone-marrow-derived mesenchymal stem cells, were evaluated. The effect of Strontium on physico-chemical and morphological properties of hydroxyapatite gel were evaluated. Morphological analyses (SEM and TEM) demonstrate that an increasing in the amount of Sr ions doped into HA made the agglomerated particles smaller. The substitution of large Sr2+ for small Ca2+ lead to denser atomic packing of the system causing retardation of crystals growth. The biological results demonstrated that hydroxyapatite gel containing from 0 to 20 mol% of Sr presented no cytotoxicity and promote the expression of osteogenesis related genes including an early marker for osteogenic differentiation ALP; a non-collagen protein OPN and a late marker for osteogenic differentiation OCN. Finally, the Sr-HA gels could have a great potential application as filler in bone repair and regeneration and used in especially in the osteoporotic disease.

Direct cytotoxicity evaluation of 63S bioactive glass and bone-derived hydroxyapatite particles using yeast model and human chondrocyte cells by microcalorimetry

In this study, the cytotoxicity evaluation of prepared 63S bioactive glass and bone-derived hydroxyapatite particles with yeast and human chondrocyte cells was carried out using isothermal micro-nano calorimetry (IMNC), which is a new method for studying cell/biomaterial interactions. Bioactive glass particles were made via sol-gel method and hydroxyapatite was obtained from bovine bone. Elemental analysis was carried out by XRF and EDXRF. Amorphous structure of the glass and completely crystalline structure of HA were detected by XRD analysis. Finally, the cytotoxicity of bioactive glass and bone-derived HA particles with yeast and cultured human chondrocyte cells was evaluated using IMNC. The results confirmed the viability, growth and proliferation of human chondrocyte cells in contact with 63S bioactive glass, and bone-derived HA particles. Also the results indicated that yeast model which is much easier to handle, can be considered as a good proxy and can provide a rapid primary estimate of the ranges to be used in assays involving human cells. All of these results confirmed that IMNC is a convenient method which caters to measuring the cell-biomaterial interactions alongside the current methods.

Histological Evaluation of Apatite Cement Containing Atelocollagen

Tissue response to apatite cement (AC) containing atelocollagen (AC (ate)) was evaluated using conventional AC (c-AC) as a control material. At one week, the only difference between AC (ate) and c-AC was found in the soft tissue response. With c-AC, a moderate inflammatory response was exhibited: small particles of c-AC were scattered in the cutaneous tissue and many foreign body giant cells were aggregated around the scattered c-AC, whereas AC (ate) showed only a slight inflammatory response with few foreign body giant cells. In terms of bone tissue response, difference between AC (ate) and c-AC was observed at four weeks. New bone formation was observed along the cement at the edge of the pre-existing cortical bone in both c-AC and AC (ate). However, in the case of AC (ate), more abundant and thicker new bone was formed along the cement in the bone marrow when compared with c-AC.

Premixed calcium phosphate cements: synthesis, physical properties, and cell cytotoxicity

OBJECTIVES

Calcium phosphate cement (CPC) is a promising material for dental, periodontal, and craniofacial repairs. However, its use requires on-site powder-liquid mixing that increases the surgical placement time and raises concerns of insufficient and inhomogeneous mixing. The objective of this study was to determine a formulation of premixed CPC (PCPC) with rapid setting, high strength, and good in vitro cell viability.

METHODS

PCPCs were formulated from CPC powder+non-aqueous liquid+gelling agent+hardening accelerator. Five PCPCs were thus developed: PCPC-Tartaric, PCPC-Malonic, PCPC-Citric, PCPC-Glycolic, and PCPC-Malic. Formulations and controls were compared for setting time, diametral tensile strength, and osteoblast cell compatibility.

RESULTS

Setting time (mean+/-S.D.; n=4) for PCPC-Tartaric was 8.2+/-0.8 min, significantly less than the 61.7+/-1.5 min for the Premixed Control developed previously (p<0.001). On 7th day immersion, the diametral tensile strength of PCPC-Tartaric reached 6.5+/-0.8 MPa, higher than 4.5+/-0.8 MPa of Premixed Control (p=0.036). Osteoblast cells displayed a polygonal morphology and attached to the nano-hydroxyapatite crystals in the PCPCs. All cements had similar live cell density values (p=0.126), indicating that the new PCPCs were as cell compatible as a non-premixed CPC control known to be biocompatible. Each of the new PCPCs had a cell viability that was not significantly different (p>0.1) from that of the non-premixed CPC control.

SIGNIFICANCE

PCPCs will eliminate the powder-liquid mixing during surgery and may also improve the cement performance. The new PCPCs supported cell attachment and yielded a high cell density and viability. Their mechanical strengths approached the reported strengths of sintered porous hydroxyapatite implants and cancellous bone. These nano-crystalline hydroxyapatite cements may be useful in dental, periodontal, and craniofacial repairs.

Cytotoxicity and fibroblast properties during in vitro test of biphasic calcium phosphate/poly-dl-lactide-co-glycolide biocomposites and different phosphate materials

Reconstruction of bone defects is one of the major therapeutic goals in various clinical fields. Bone replacement materials must satisfy a number of criteria. Biological criteria are biocompatibility, controlled biodegradability, and osteoconductive or even osteogenic potential. The material should have a three-dimensional structure with an interconnected pore system so as to permit cell growth and transport of substances. The surface must permit cell adhesion and proliferation. Composite biomaterials have enormous potential for natural bone tissue reparation, filling and augmentation. Calcium hydroxyapatite/polymer composite biomaterials belong to this group of composites and, because of their osteoconductive and biocompatible properties, can be successfully implemented within bone tissue reparations. In this study, possible differences between BCP/DLPLG, pure BCP, and Bio-Oss materials were examined in vitro. During overnight incubations, fibroblast and fibroblast-like cells (L929, MRC5) were able to adhere, spread, and remain viable on BCP, BCP/PLGA, and Bio-Oss discs, as was evidenced by using light- and LVSEM-microscopy. Inhibiting influence over the cell growth is more pronounced in the cases of BCP usage on both cell lines--41.29% for L929 and 43.08% for MRC-5 cells. MRC-5 cells are, within the given experimental conditions, less sensitive on inhibiting effects for the materials BCP/PLGA and Bio-Oss (10.13% and 10.76%, respectively) than for the L929 cell lines (23.02% and 15.44%, respectively).

Physico-chemical characterization and biocompatibility evaluation of hydroxyapatites

The aim of this study was to evaluate the physico-chemical and biocompatibility characteristics of two different hydroxyapatites. Physical and chemical properties were analyzed using granulometric analysis, scanning electron microscopy (SEM), X-ray energy-dispersion (EDX), X-ray fuorescence (XRF) and X-ray diffraction (XRD). Biomaterials were implanted into the subcutaneous tissue on the dorsum of 36 Wistar rats, divided into the following groups: Group 1 - Gen-Ox (natural); Group 2 - HA-U (synthetic) and Group 3 - Control (Sham). After 15 and 30 days, 6 animals/period were sacrificed and the subcutaneous tissue was taken for histological and histometric analysis, giving consideration to inflammatory reaction and granule area. The granulometric test results showed a mean granule diameter of 161.6 microm (min = 19.0 microm; max = 498.0 microm) and 48.7 microm (min = 7.0 microm; max = 256.0 microm) for groups 1 and 2 respectively. Analysis with SEM demonstrated irregular and sharp-edge particles in group 1 (3332.8 +/- 274.3 microm(2)) and irregular and rounded particles in group 2 (1320.8 +/- 83.0 microm(2)) (P < 0.0001; Student's t test). EDX and XRF revealed calcium, carbon, oxygen, sodium and phosphorus in both groups. XRD indicated that both biomaterials were pure and crystalline. There was a statistically significant difference in granule area between the two groups after 15 days (P = 0.022; Student's t-test). After 15 days, an increased inflammatory response was seen in group 2 (P < 0.0001; ANOVA and Tukey's post hoc test) whereas it was more pronounced in group 1 after 30 days (P < 0.0001; ANOVA and Tukey's post hoc test). It was concluded that these biomaterials have similar physical, chemical and biocompatibility characteristics.

Repair of bone defects by applying biomatrices with and without autologous osteoblasts

QUESTION

Is it possible to stimulate osteoconduction and osteogenesis to improve bone formation in critical-size defects in order to avoid bone grafting?

MATERIAL AND METHODS

Full thickness, critical-sized defects were created in the anterior mandible of 16 adult mini-pigs. The defects were filled with a new bioactive matrix (60% hydroxyapatite and 40% beta-tricalciumphosphate), produced by an innovative low temperature sol-gel-process (120 degrees C). The biomatrix was tested alone and in combination with cultured autologous osteoblasts. In a control group, periosteum was the only bone producing source. Five weeks postoperatively, the animals were sacrificed and the defects analysed macroscopically, histologically and radiographically.

RESULTS

The highest rate of new bone formation was in the biomatrix group without osteoblasts (73% of the former defect). The biomatrix was degraded at the same speed as new bone was laid down. In the control group, bone formation of only 59% was observed. Additional transplantation of autologous osteoblasts in combination with the biomatrix did not result in more bone production than in the control group(!).

CONCLUSION

This new bioactive calciumphosphate matrix seems to be a promising bone replacement material.

Chromosome aberration test for hydroxyapatite in sheep

The present study is aimed at finding the mutagenicity and cytotoxicity of dense form of synthetic hydroxyapatite (Source: School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia) in the blood of sheep. The biomaterial was implanted in the tibia of Malin, an indigenous sheep breed of Malaysia. Blood was collected from the sheep before implantation of the biomaterial, cultured and a karyological study was made. Six weeks after implantation, blood was collected from the same animal, cultured and screened for chromosome aberrations. The mitotic indices and karyological analysis indicated that the implantation of synthetic hydroxyapatite (dense form) did not produce any cytotoxicity or chromosome aberrations in the blood of sheep.

DNA damage evaluation of hydroxyapatite on fibroblast cell L929 using the single cell gel electrophoresis assay

Hydroxyapatite is the main component of the bone which is a potential biomaterial substance that can be applied in orthopaedics. In this study, the biocompatibility of this biomaterial was assessed using an in vitro technique. The cytotoxicity and genotoxicity effect of HA2 and HA3 against L929 fibroblast cell was evaluated using the MTT Assay and Alkaline Comet Assay respectively. Both HA2 and HA3 compound showed low cytotoxicity effect as determined using MTT Assay. Cells viability following 72 hours incubation at maximum concentration of both HA2 and HA3 (200 mg/ml) were 75.3 +/- 8.8% and 86.7 +/- 13.1% respectively. However, the cytotoxicity effect of ZnSO4.7H2O as a positive control showed an IC50 values of 46 mg/ml (160 microM). On the other hand, both HA2 and HA3 compound showed a slight genotoxicity effect as determined using the Alkaline Comet Assay following incubation at the concentration 200 mg/ml for 72 hours. This assay has been widely used in genetic toxicology to detect DNA strand breaks and alkali-labile site. The percentage of the cells with DNA damage for both substance was 27.7 +/- 1.3% and 15.6 +/- 1.0% for HA2 and HA3 respectively. Incubation of the cells for 24 hours with 38 microg/ml (IC25) of positive control showed an increase in percentage of cells with DNA damage (67.5 +/- 0.7%). In conclusion, our study indicated that both hydroxyapatite compounds showed a good biocompatibility in fibroblast cells.

In vitro cytotoxicity evaluation of biomaterials on human osteoblast cells CRL-1543; hydroxyapatite, natural coral and polyhydroxybutarate

The aim of this study was to evaluate the in vitro cytotoxicity of biomaterials; Hydroxyapatite (HA), Natural coral (NC) and Polyhydroxybutarate (PHB). Three different materials used in this study; HA (Ca10(PO4)6(OH)2), NC (CaCO3) and PHB (Polymer) were locally produced by the groups of researcher from Universiti Sains Malaysia. The materials were separately extracted in the complete culture medium (100mg/ml) for 72h and introduced to the osteoblast cells CRL-1543. The viability of osteoblast CRL-1543 cultivated with these extraction materials after 72h incubation period was compared to negative control with neutral red assay by using spectrophotometer at 540nm. The results showed the non-cytotoxicity of the materials. After 72h of incubation period, HA showed 123% viable cells, NC was 99.43% and PHB was 176.75%. In this study, cytotoxicity test dealt mainly with the substances that leached out from the biomaterial. The results obtained showed that the materials were not toxic and also promoted cells growth in the sense of biofunctionality.

In vitro cytotoxicity testing on valued added hydroxyapatite as bone replacement material

The present in vitro evaluation indicated that the value added hydroxyapatite (HA) was more toxic than pure HA but the toxicity of value added HA was slight compared to the positive control. In this testing, the conclusion can be made that value added HA is less biocompatible than commercialized pure HA. This toxicity may be caused by both the particle size and degradation (leaching). Further studies should be carried out to determine whether there is particle size effect or leaching effect when using powder as compared to the block materials. The in vivo evaluation should be done to assess the reaction to this value added HA as compared to the pure HA.

Gene expressions screening of human cell line exposed to locally produced biomaterial

In Malaysia, the field of genomics in toxicology is still in infancy. The purpose of this study is to focus on the use of toxicogenomics for determination of gene expressions changes in cultured human fibroblast cells treated with genotoxicology free biomaterial (using Ames test), a locally produced hyroxyapatite. Dose and time response is similar to Ames test with time interval up to 21 days. mRNA is extracted, followed with RT-PCR and polyacrilamide gel electrophoresis. Changes of the gene expressions compared to the non-treated fibroblast mRNA would suggest some gene interactions in the molecule level associated with the exposure of the fibroblast cell line to the biomaterials. Further analysis (cloning & sequencing) shall be carried out to investigate the genes involved as simple changes might not signified toxicity.

Mutagenicity of CORAGRAF and REKAGRAF in the Ames test

Mutagenicity of CORAGRAF (natural coral) and REKAGRAF (hydroxyapatite) was tested in Ames test with and without an external metabolic activation system (S9). The test revealed no mutagenic activity of both locally produced osseous substitutes.

[Experimental study in vitro on toxicology and cytocompatibility of collagen/hydroxylapatite (CHA) composite material as part of tracheal prosthesis]

Cytotoxicity and cytocompatibility remains the principal theme for biomaterials application in medicine. The purpose of this study was to investigate the cytotoxicity and cytocompatibility of collagen/hydroxyapatite(CHA) composite material in vitro in order to provide useful scientific basis for clinical use. Cellular cultivation in vitro and MTT assay were conducted for evaluating the composite material's influence on the morphology, growth and proliferation of cultured cell(L-929 cell). The hemolysis test was also performed for evaluating the impact on the function and metabolism of erythrocyte. These results demonstrated that the CHA composite material had no cytotoxicity and no hemolytic effect, and it might not be harmful to the morphology of the L-929 cell. The growth and proliferation of the L-929 cell could not be inhibited significantly. The cytotoxicity score of the composite material was grade 0. The hemolysis rate was 1.85%. In conclusion, collagen/hydroxyapatite (CHA) composite material might have good cytocompatibility and be safe for clinical use.

Biological reactivity of zirconia-hydroxyapatite composites

Materials and devices intended for end-use applications as implants and medical devices must be evaluated to determine their biocompatibility potential in contact with physiological systems. The use of standard practices of biological testing provides a reasonable level of confidence concerning the response of a living organism to a given material or device, as well as guidance in selecting the proper procedures to be carried out for the screening of new or modified materials. This article presents results from cytotoxicity assays of cell culture, skin irritation, and acute toxicity by systemic and intracutaneous injections for powders, ceramic bodies, and extract liquids of hydroxyapatite (HA), calcia partially stabilized zirconia (ZO), and two types of zirconia-hydroxyapatite composites (Z4H6 and Z6H4) with potential for future use as orthopedic and dental implants. They indicate that these materials present potential for this type of application because they meet the requirements of the standard practices recommended for evaluating the biological reactivity of ATCC cell cultures (CCL1 NCTC clone 929 of mouse connective tissue and CCL 81 of monkey connective tissue) and animals (rabbit and mouse) with direct or indirect patient contact, or by the injection of specific extracts prepared from the material under test. In addition, studies involving short-term intramuscular and long-term implantation assays to estimate the reaction of living tissue to the composites studied, and investigations on long-term effects that these materials can cause on the cellular metabolism, are already in progress.

[Study on osteocompatibility of hydroxyl polycalcium sodium phosphate in vitro]

Hydroxyl polycalcium sodium phosphate(HP) is a new substitute material for human hard tissues. The isolated rat osteoblasts from the parietal and frontal bones of 1-3d SpragueDawley rats were used to estimate the osteocompatibility of HP in this study. The effects of the materials on cell morphology, growth and proliferation were determined. The result showed that rat osteoblasts could attach, spread and proliferate on HP as normal cells. The proliferation of cells on HP was more favour able to the adhesion and proliferation of rat osteoblasts and could form osteointegration early.

[Experimental study on the biocompatibility and toxicology of interface between hydroxyapatite coating and bone]

According to "The standards for biological evaluation of bio-materials and bio-products abbreviated to STANDARDS" newly set by the Ministry of Health, PRC, 5 observation indexes were selected to evaluate systematically the biocompatibility and toxicology of China-made hydroxyapatite, which is clinicall used. The results revealed no effects of allergy, mutation and hemoclasis reaction except mild cytotoxicity. These indicate that the China-made hydroxyapatite meets the demand of STANDADS and thus may be clinically with safety.

The investigation of biocompatibility and apical microleakage of tricalcium phosphate based root canal sealers

The biocompatibility and apical microleakage of tricalcium phosphate based Sankin Apatite (SA) Type I, II, and III root canal sealers were investigated. Teflon tubes containing freshly mixed test materials were implanted in the subcutaneous tissue of mice. The observation periods were 24 h, 7, and 30 days, after which the areas of tissue reaction to the implanted materials were histopathologically analyzed. A dye-recovery, spectrophotometric method was used to evaluate apical microleakage. Results showed that the severity of tissue reaction among the tested materials decreased with time and at the end of the observation period both SA Type II and Type III were found more biocompatible than either Type I or Grossman's cement (GC). On the other hand, a fibrous tissue capsule was seen around the implants. There was no significant difference in spectrophotometrically measured leakage among teeth obturated with the test materials.

Mechanical and histological investigation of hydrothermally treated and untreated anodic titanium oxide films containing Ca and P

In a previous study a new method for forming thin hydroxyapatite (HA) layers on titanium was described. Titanium was anodized at 350 V in an electrolyte solution containing sodium beta-glycerophosphate and calcium acetate, and an anodic titanium oxide film containing Ca and P (AOFCP) was formed on the surface. Then numerous HA crystals were precipitated on the AOFCP during hydrothermal treatment in high-pressure steam at 300 degrees C. In this study three types of hydrothermally treated films differing in amounts of precipitated HA crystals and tensile adhesive strength, and untreated films were histologically and mechanically investigated in a transcortical rabbit femoral model for 8 weeks of implantation using light microscopy, scanning electron microscopy (SEM), and push-out tests. Machined titanium and HA ceramics served as control materials. The push-out shear strength and bone apposition of the AOFCP significantly increased after hydrothermal treatment, and were equivalent to those of HA ceramics, although the HA layer on the AOFCP was thin at 1-2 microns. From SEM observation of the pushed-out specimen, it was found that the thin HA layer had directly bonded to bone but the AOFCP had not. The push-out strength of the hydrothermally treated film resulted from the chemical bonding of the bone-HA layer interface, while that of the untreated film resulted from mechanical interlocking force between bone and the microprojections. There was a small difference in bone apposition but no significant difference in push-out strength with the amount of precipitated HA crystals on the treated films. Among the treated films, the film formed at the lowest electrolyte concentration showed the lowest bone apposition because of incomplete covering by the HA crystals, and showed the highest stability against mechanical failure because the adhesive strength was very high at about 38 mPa. Also, the hydrothermally untreated anodic oxide films, whose surfaces were rough as a result of the large microprojections, showed much higher push-out strength and bone apposition than titanium. The good hard-tissue compatibility may be attributed to the surface roughness and the possible inhibition of titanium ion release from the specimen.

Do porous calcium hydroxyapatite ceramics cause porosis in bone? A bone densitometry and biomechanical study on cortical bones of rabbits

Porous calcium hydroxyapatite (CHA) ceramics are biocompatible and present osteoconductive properties. These ceramics are widely used in orthopaedic surgery; however, it is not yet known whether they have some adverse effects on bone and bone marrow healing. Our previous radiological study revealed possible local porosis at the adjacent sites of the CHA ceramic. Histological findings of the same study revealed bone marrow swelling and depletion at the implantation site. Osteoclasts removed particles of the implant that may be the cause of local porosis. In the present study, possible local osteoporosis was evaluated by bone densitometry analyses, and compression and three-point bending tests. CHA particles were implanted into the left limbs and a sham operation was utilized on the right limbs of 75 white rabbits. The animals were followed up for 23 weeks for bone mineral density and for 6 months for biomechanical analyses. The CHA implanted area and its distal or proximal adjacent areas were evaluated with a Hologic QDR-2000 bone densitometer. Three-point bending and compression tests were performed with an M-30 K material testing device. The results revealed a time-dependent bone density increase at the CHA implantation site and no significant porosis at adjacent areas of the implant. The stiffness of CHA-implanted bones in three-point bending is larger than that of the control group. CHA-implanted rabbit bones presented a different fracture pattern from the control group. The stiffness of the control and CHA-implanted bones generally increased with time indicating no adverse effects of porous CHA ceramics in bone and bone marrow healing. The clinical relevance of this work is that porous CHA ceramics do not cause local porosis at adjacent areas when implanted into osseous sites.(ABSTRACT TRUNCATED AT 250 WORDS)

[Evaluation of the biocompatibility of implant materials with human bone marrow cell cultures]

A cell culture biocompatibility test for implant materials is described. For the first time, the human bone marrow cells that actually come into direct contact with the implanted biomaterial can be employed. The usefulness of this method is shown for materials which have long been used in the clinical situation (hydroxyapatite, commercially pure titanium and ultra-high molecular weight polyethylene). After two weeks in culture, light- and fluorescence-microscopic and SEM studies revealed significant differences in cell growth. Maximum compatibility was shown by the hydroxyapatite specimen. In the case of commercially pure titanium we found somewhat decreased biocompatibility. Polyethylene was associated with distinct signs of cytotoxicity. These results are compatible with those of animal experiments and clinical experience. Our system would thus appear to be a useful screening test for some implantation materials, and may help reduce the need for animal tests.

Histologic investigation of the biologic behavior of different hydroxyapatite plasma-sprayed coatings in rabbits

The aim of this study was to investigate bone response to and biostability of three different hydroxyapatite (HA)-coatings. Therefore, coated and uncoated titanium implants were inserted into the tibia of rabbits. Implantation times were at 3 and 12 weeks. The histological evaluation included measurement of the amount of bone apposition to the various implant surfaces. The results demonstrated at 3 and 12 weeks no marked differences in bony reaction at the cortical level to the different implant materials. However, compared with the 3-week specimens, at 12 weeks extensive maturation of the woven bone callus had occurred. In addition, all 12-week implants induced bone formation in the medullary cavity. It was also noted that all HA-coatings showed loss of coating thickness. Quantitative determination of bone contact demonstrated that all 12-week implants showed the same high amount of bone apposition.

Evaluation of biocompatibility of various ceramic powders with human fibroblasts in vitro

Cell reaction to powders of ceramics was studied in vitro. Cultured human fibroblasts were exposed to different types of ceramic powders: zirconia (ZP), alumina (A), tricalcium phosphate (TCP) and hydroxyapatite (HA), at various concentrations. The cell viability at the different exposure times was measured by the colony formation (expressed as colony forming efficiency, CFE), neutral red uptake (NR) and colorimetric tetrazolium (MTT) reduction. Alumina and hydroxyapatite showed no cytotoxic effects at studied doses (1-500 mug/ml) while zirconia and tricalcium phosphate inhibited cell viability, with 50% of CFE reduction at the concentration of about 50 mug/ml. In order to study the cytotoxic mechanism of zirconia powder, two further experiments were included, viz. the cellular response to the sintered zirconia ceramic powders (CZP) which were obtained by crushing the sintered ceramic material; and the measurement of the degradation of zirconia ceramic plate in the different solutions, i.e., either in saline or in 0.02 M lactic acid (pH 2.72). Similar cell reactions were obtained for the CZP and ZP by using MTT and NR assays. Slow releases of ions from zirconia ceramic plate, yttrium in both solutions and zirconium and yttrium in lactic acid, were detected.

Permucosal implantation pilot study with HA-coated dental implant in dogs

The histological response of transmucosal one-stage titanium dental implants coated with hydroxyapatite is described. The gingival adhesion to the implant was examined with regard to coated, partially coated or non-coated surfaces in the cervical region. From each coating type, 9 implants were inserted into dogs. Six months after the insertion, 19 implants could be evaluated, but 8 implants were lost. From these 19 implants, 6 implants showed severe pockets with inflammation up to the bony tissue. The 13 successful implants showed direct bone bonding with the hydroxyapatite coating and adhesion of submucosal connective tissue to the implant surface, with inflammation. The marginal gingiva showed slight inflammation. A totally coated implant will probably introduce inflammation by debris formation against the rough implant surface more easily. The hydroxyapatite coating often disappeared in the soft tissue or in the oral cavity. Bone which directly adapted to the coating seemed to prevent it from resorption.

Development of a new percutaneous access device for implantation in soft tissues

The objective of this study was to evaluate a new type of percutaneous device (PD) designed to be implanted in soft tissues. The new PD consisted out of: (1) a flange-shaped subcutaneous component, made from sintered titanium fiber-web, and (2) a percutaneous component, made from dense sintered hydroxyapatite. The PDs were inserted in the back of 15 rabbits. The surgical procedure was performed in two steps. In the first session the subcutaneous component was placed. In the second session, after 3-4 months the percutaneous component was fixed in the subcutaneous component. The implants were left in situ for 1 and 4 months after the second implantation session. Clinical and histological investigations were performed. It is found, that there was only a limited epidermal down-growth in the percutaneous area. No inflammatory reaction was observed in the dermal connective tissue. Histological analysis also demonstrated that titanium fiber mesh evokes minor adverse effects of the surrounding tissues. In conclusion, these experiments have shown that stabilization of the PD in the hypodermal area by using a sintered titanium fiber-web structure favors the longevity of PDs implanted in soft tissues.

[Synthesizing and biological quality of hydroxyapatite (HAP) ceramics]

Hydroxyapatite (HAP) ceramics were prepared by dry method from Ca3(PO4)2 and CaCO3. The compounds were single crystals of HAP. The biological tests, according to the test standard of biological quality, including cell culture cytotoxicity assay, pyrogenicity, hemolysis assay, systemic injection acute toxicity assay and implant usage assay in animal for the material have been performed. The results showed that the material has no any toxicity and stimulation for organism, has superior histocompatibility and ability to bind directly to bone. The particles of HAP have been used clinically for mandibular cyst and alveolus implants presently. The initial observation has shown that the wounds are all healed well and there is no any adverse reaction for the patients.

Toxicity of hydroxyapatite in vitro: the effect of particle size

Finely ground powders of synthetic hydroxyapatite applied to fibroblasts in vitro reduced the total growth rate and mitotic rate of the cells and increased the number of pycnotic cells. The effect was dose related and only occurred with small particles. The small particles appear to either adhere to the cells or are phagocytosed by them and the toxic effect may be physical rather than chemical.

Clinico-pathological studies on the tissue reactions of human pulp treated with various kinds of calcium phosphate ceramics

The aim of this study was to evaluate the clinical values of calcium phosphate ceramics from the biological point of view. Two kinds of calcium phosphate ceramics, tricalcium phosphate (TCP) and hydroxyapatite (HAP) ceramics with a low sintering temperature (LT) and a high sintering temperature (HT), were applied to exposed pulp wounds in ninety healthy human teeth. Each group was further subdivided into 2 groups with selected granule diameters of 5 microns (S) and 40 microns (L), and investigated clinico-pathologically. Clinically, cases showing some kinds of discomfort symptoms comprised 3/15 of the TCP (S) group, 3/15 of the TCP(L) group, 3/15 of the LT(S) group, 4/15 of the LT(L) group, 2/15 of the HT(S) group, and 3/15 of the HT(L) group. The symptoms were generally slight or very slight and disappeared within eight days in the LT(S) group. Histo-pathologically, inflammatory reactions were observed within 2 weeks. Traumatic injury caused by surgical wound or by mechanical irritation from the materials produced various pathological changes. After the treatment, pulp manifested reparative changes such as cicatrization, formation of new denticles, and dentin apposition on pulp-chamber walls. In many cases, TCP and HAP produced similar effects on human dental pulp. In the TCP(S), the LT(S), and HT(S) groups, a calcified matrix had appended by 3 weeks. In TCP(L), LT(L), and HT(L) groups, the matrix had appended from 3 to 6 weeks. Calcified matrix formation in the LT group was slightly less than in that in the HT of HAP group. In a few cases, complete dentin bridges formed over the exposed pulp surfaces. These results suggest that HAP (both LT and HT) and TCP ceramics are biocompatible and do not harm human dental pulp. These ceramics were found to be clinicopathologically effective in biologically protecting exposed human dental pulp and useful as basic materials in endodontic therapy.

Histological study of furcation perforations treated with tricalcium phosphate, hydroxylapatite, amalgam, and Life

One-hundred twenty experimental furcation perforations were created in the mandibular and maxillary premolars and molars of six rhesus monkeys. Tricalcium phosphate, hydroxylapatite, amalgam, and Life were used to repair the furcation perforations. The animals were sacrificed at the intervals of 2, 4, and 6 months after the experiment. Histological evaluation revealed lack of complete healing of furcation perforations repaired with any materials. Epithelium was present in the furcation perforations in both experimental and positive control groups. No hard tissue formation was observed in this study. Inflammation in the furcation area may be due to inadequate sealing ability of the repair materials.

Quantitative analysis of in vivo tissue responses to titanium-oxide- and hydroxyapatite-coated titanium alloy

We have previously studied a large number of histological specimens of biomaterials and found that regions with and without an intervening fibrous membrane coexisted in many specimens. Therefore, it appears necessary to perform an evaluation of the entire specimen when histologically assessing the affinity of bone for a biomaterial. Accordingly, we performed a quantitative histological evaluation of hydroxyapatite (HAP)- and titanium-oxide(TiO2)-coated Ti-6A1-4V and uncoated Ti-6A1-4V (control) by determining the affinity index. This was defined as the length of bone directly opposed to the implant/the total length of the bone-implant interface X 100%. The test materials were inserted into the distal epiphyseal region of the femurs of adult dogs, and follow-up quantitative histological comparisons were performed from 4 weeks to 96 weeks. The HAP-coated implants had the highest affinity index 4 weeks after insertion, and this superiority was maintained up to 96 weeks. There was a significant difference in affinity index between HAP-coated implants and control implants (P less than 0.001), while TiO2-coated implants showed no significant difference in comparison to the control.

[6 dentin adhesive products subjected to controls in vitro]

The aim of this in vitro study was to assess of the biocompatibility of 6 adhesive dental products (Cavalite, Dual Cement, Fuji Type II, Gluma, Ketac Bond, Scotch Bond) using cell cultures of human pulps and a standardized method. It was thus possible to improve the scale of biological activity proposed by Regad et al., (1989). The specific behaviour of the cells in the contact and adjacent zones has been added to the assessment of the cellular reactions of the whole culture. These criteria allowed the clear differentiation of the toxicity and the biocompatibility of the products. The following estimations were made: Gluma and Fuji Type II "toxic", Cavalite "acceptable", Scotch Bond "not significant", Ketac bond and Dual Cement "acceptable" and "not significant" with a "toxic" tendency.

Incomplete polymerization of Cavalite with the use of recommended photopolymerization times: a warning of possible cytotoxic effects

As part of a study of the suitability of new materials for use as a retrofilling material, we examined the polymerization properties of Cavalite, a light-cured, hydroxyapatite and glass ionomer-containing cavity liner. By varying the time of photopolymerization, it was found that polymerization for 20 to 30 seconds according to the manufacturer's recommendations is not sufficient to ensure complete polymerization. The implications of this incomplete polymerization are discussed in terms of possible cytotoxic effects on tissues exposed to unpolymerized Cavalite, both when used in retrofilling situations and as a deep cavity liner.

[Comparative test of the soluble toxicity of hydroxyapatite ceramics using human and animal osteoblasts]

The soluble toxicity of 5 different hydroxylapatite granulates was tested in osteoblast cell cultures. We established a human osteoblast-like cell culture and a culture of rat (Lewis) osteoblast-like cells. The granulates were also tested in cultures of human gingival fibroblasts as a conventional system. It is demonstrated that the osteoblast-like cell cultures are of higher sensitivity than fibroblast cultures which do not show any reaction to the extracts of hydroxylapatite granulates. Only 2 hydroxylapatite granulates show some toxic. The human osteoblast-like cells reacted slightly more sensitive to toxic substances of the materials tested than rat osteoblast-like cells. It is demonstrated that the osteoblast-like cell cultures are a highly sensitive test system for materials with low toxicity.

Interleukin 1 (IL 1) as a mediator of crystal arthritis. Stimulation of T cell and synovial fibroblast mitogenesis by urate crystal-induced IL 1

We reported before that monosodium urate (MSU) crystals were potent stimulators of endogenous pyrogen (EP) production from human and rabbit mononuclear phagocytes, and proposed that this property of MSU crystals may be important in the pathogenesis of gout. EP activity is now attributed to interleukin 1 (IL 1) peptides but IL 1 is not the only pyrogenic monocyte-derived cytokine, since both interferon-alpha (alpha-IFN) and tumor necrosis factor (TNF) are also pyrogenic in rabbits. Using a T cell comitogenic assay based on a murine helper T cell clone that does not respond to IFN or TNF, we now report the release of IL 1 activity from human blood monocytes and synovial fluid mononuclear cells (MNC), following stimulation with MSU crystals. MSU-induced supernatants with IL 1 activity were neutralized with rabbit antiserum to human IL 1 and also stimulated the growth ([3H]thymidine incorporation) of long-term fibroblast-like cell lines derived from human synovial rheumatoid exudate. Two other crystals associated with articular inflammation were tested: hydroxyapatite was a much less potent stimulus compared with MSU crystals, and calcium pyrophosphate dihydrate did not stimulate IL 1 release from human monocytes or synovial fluid MNC. As a model for the inflammatory consequences of acute and chronic overproduction of IL 1, gout is the only sterile inflammatory disease where the local and systemic pathology is compatible with such overproduction; raised IL 1 levels have been found at the site of inflammation, and a necessary etiologic agent, crystalline urate, has been shown unequivocally to be a direct activator of mononuclear IL 1 release.

Hydroxyapatite ceramic as middle ear implant material: animal experimental results

Hydroxyapatite is the main constituent of the mineral matrix of bone. The behavior of porous and dense hydroxyapatite ceramic implants was studied in normal rat middle ears, after induced infection, and in an in vitro assay by light and electron microscopic techniques. All implants were integrated into the middle ears without signs of extrusion, and their mucosal coverings did not appear to differ fundamentally from those of normal ears. The porous hydroxyapatite became filled with fibrous tissue and bone that showed normal morphology, and there was direct bonding of the bone to the implants. Minor biodegradation was established for the porous implants. Hydroxyapatite did not affect cultured middle ear mucosa significantly in vitro. Induced infection failed to show any adverse effect on the behavior of the implants. These observations suggest that hydroxyapatite is very useful for reconstructive ear surgery.

DNA replication, repair, and repair tests

The rate of inhibition and recovery of DNA synthesis can be used in a rapid assay system to detect genotoxic potentials of chemicals. Also, the observation that an agent stimulates DNA repair in a test system indicates its ability to cause damage in DNA. Different experimental approaches to the study of repair synthesis are discussed.