Nanoapatite and organoapatite implants in bone: histology and ultrastructure of the interface

Expression of Vascular Endothelial Growth Factor Using Platelet Rich Fibrin (PRF) and Nanohydroxyapatite (nano-HA) in Treatment of Periodontal Intra-Bony Defects - A Randomized Controlled Trial

The study aims to assess the concentration of vascular endothelial growth factors (VEGF) with platelet rich fibrin (PRF) biomaterial, while using it separately or in combination with nanohydroxyapatite (nano-HA) for treating intra-bony defects (IBDs) using radiographic evaluation (DBS-Win software). Sixty patients with IBD (one site/patient) and chronic periodontitis were recruited randomly to test either autologous PRF platelet concentrate, nano-HA bone graft, a combination of PRF platelet concentrate and nano-HA, or alone conventional open flap debridement (OFD). Recordings of clinical parameters including probing depth (PD), gingival index (GI), and clinical attachment level (CAL) were obtained at baseline and 6 months, post-operatively. One-way analysis of variance (ANOVA) was used to compare four groups; whereas, multiple comparisons were done through Tukey’s post hoc test. The results showed that CAL at baseline changed from 6.67 ± 1.23 to 4.5 ± 1.42 in group I, 6.6 ± 2.51 to 4.9 ± 1.48 in group II, 5.2 ± 2.17 to 3.1 ± 1.27 in group III, and 4.7 ± 2.22 to 3.7 ± 2.35 in group IV after 6 months. The most significant increase in bone density and fill was observed for IBD depth in group III that was recorded as 62.82 ± 24.6 and 2.31 ± 0.75 mm, respectively. VEGF concentrations were significantly increased at 3, 7, and 14 days in all groups. The use of PRF with nano-HA was successful regenerative periodontal therapy to manage periodontal IBDs, unlike using PRF alone. Increase in VEGF concentrations in all group confirmed its role in angiogenesis and osteogenesis in the early stages of bone defect healing.

Spatial Presentation of Tissue-Specific Extracellular Matrix Components along Electrospun Scaffolds for Tissue Engineering the Bone-Ligament Interface

The bone-ligament interface transitions from a highly organized type I collagen rich matrix to a nonmineralized fibrocartilage region and finally to a mineralized fibrocartilage region that interfaces with the bone. Therefore, engineering the bone-ligament interface requires a biomaterial substrate capable of maintaining or directing the spatially defined differentiation of multiple cell phenotypes. To date the appropriate combination of biophysical and biochemical factors that can be used to engineer such a biomaterial substrate remain unknown. Here we show that microfiber scaffolds functionalized with tissue-specific extracellular matrix (ECM) components can direct the differentiation of MSCs toward the phenotypes seen at the bone-ligament interface. Ligament-ECM (L-ECM) promoted the expression of the ligament-marker gene tenomodulin (TNMD) and higher levels of type I and III collagen expression compared to functionalization with commercially available type I collagen. Functionalization of microfiber scaffolds with cartilage-ECM (C-ECM) promoted chondrogenesis of MSCs, as evidenced by adoption of a round cell morphology and increased SRY-box 9 (SOX9) expression in the absence of exogenous growth factors. Next, we fabricated a multiphasic scaffold by controlling the spatial presentation of L-ECM and C-ECM along the length of a single electrospun microfiber construct, with the distal region of the C-ECM coated fibers additionally functionalized with an apatite layer (using simulated body fluid) to promote endochondral ossification. These ECM functionalized scaffolds promoted spatially defined differentiation of MSCs, with higher expression of TNMD observed in the region functionalized with L-ECM, and higher expression of type X collagen and osteopontin (markers of endochondral ossification) observed at the end of the scaffold functionalized with C-ECM and the apatite coating. Our results demonstrate the utility of tissue-specific ECM derived components as a cue for directing MSC differentiation when engineering complex multiphasic interfaces such as the bone-ligament enthesis.

Histological and histomorphometric evaluation of hydroxyapatite-based biomaterials in surgically created defects around implants in dogs

BACKGROUND

The present study evaluated histologically and histometrically the efficacy of micro-, nano-, or mixed-composite of hydroxyapatite (HA) graft in treatment of surgically created defects around dental implants in mongrel dogs.

METHODS

Immediate implant was used after extraction of the lower third premolar in mongrel male dogs. Critical-size defects were created in intact proximal alveolar bone to each implant. The defects were divided randomly into four groups of two animals based on biomaterials used for treatment: 1) received no treatment (negative control); 2) defects treated with nano-HA bone graft; 3) defects treated with micro-HA bone graft; and 4) defects treated with a mixed composite of micro-HA and nano-HA. Animals were sacrificed at 2 months and histologic and histometric evaluation was performed.

RESULTS

The amount of new bone formed with nano-HA bone graft was highly more significant than that obtained by a micro- or mixed-composite of hydroxyapatite. Defects treated by mixed hydroxyapatite showed the greatest value in mean area percentage of collagen fibers using Masson trichrome stain.

CONCLUSIONS

The present study demonstrated that nano-hydroxyapatite bone graft was better than micro-HA or mixed-HA bone graft in new bone formation in standardized surgically created defects around dental implants. However, longer period is necessary to determine the time taken for complete resorption of bone graft materials and their replacement with new bone.

Comparison of nanoparticular hydroxyapatite pastes of different particle content and size in a novel scapula defect model

Nanocrystalline hydroxyapatite (HA) has good biocompatibility and the potential to support bone formation. It represents a promising alternative to autologous bone grafting, which is considered the current gold standard for the treatment of low weight bearing bone defects. The purpose of this study was to compare three bone substitute pastes of different HA content and particle size with autologous bone and empty defects, at two time points (6 and 12 months) in an ovine scapula drillhole model using micro-CT, histology and histomorphometry evaluation. The nHA-LC (38% HA content) paste supported bone formation with a high defect bridging-rate. Compared to nHA-LC, Ostim® (35% HA content) showed less and smaller particle agglomerates but also a reduced defect bridging-rate due to its fast degradation The highly concentrated nHA-HC paste (48% HA content) formed oversized particle agglomerates which supported the defect bridging but left little space for bone formation in the defect site. Interestingly, the gold standard treatment of the defect site with autologous bone tissue did not improve bone formation or defect bridging compared to the empty control. We concluded that the material resorption and bone formation was highly impacted by the particle-specific agglomeration behaviour in this study.

Nanohydroxyapatite Effect on the Degradation, Osteoconduction and Mechanical Properties of Polymeric Bone Tissue Engineered Scaffolds

BACKGROUND

Statistical reports show that every year around the world approximately 15 million bone fractures occur; of which up to 10% fail to heal completely and hence lead to complications of non-union healing. In the past, autografts or allografts were used as the “gold standard” of treating such defects. However, due to various limitations and risks associated with these sources of bone grafts, other avenues have been extensively investigated through which bone tissue engineering; in particular engineering of synthetic bone graft substitutes, has been recognised as a promising alternative to the traditional methods.

METHODS

A selective literature search was performed.

RESULTS

Bone tissue engineering offers unlimited supply, eliminated risk of disease transmission and relatively low cost. It could also lead to patient specific design and manufacture of implants, prosthesis and bone related devices. A potentially promising building block for a suitable scaffold is synthetic nanohydroxyapatite incorporated into synthetic polymers. Incorporation of nanohydroxyapatite into synthetic polymers has shown promising bioactivity, osteoconductivity, mechanical properties and degradation profile compared to other techniques previously considered.

CONCLUSION

Scientific research, through extensive physiochemical characterisation, in vitro and in vivo assessment has brought together the optimum characteristics of nanohydroxyapatite and various types of synthetic polymers in order to develop nanocomposites of suitable nature for bone tissue engineering. The aim of the present article is to review and update various aspects involved in incorporation of synthetic nanohydroxyapatite into synthetic polymers, in terms of their potentials to promote bone growth and regeneration in vitro, in vivo and consequently in clinical applications.

Fabrication, Properties and Applications of Dense Hydroxyapatite: A Review

In the last five decades, there have been vast advances in the field of biomaterials, including ceramics, glasses, glass-ceramics and metal alloys. Dense and porous ceramics have been widely used for various biomedical applications. Current applications of bioceramics include bone grafts, spinal fusion, bone repairs, bone fillers, maxillofacial reconstruction, etc. Amongst the various calcium phosphate compositions, hydroxyapatite, which has a composition similar to human bone, has attracted wide interest. Much emphasis is given to tissue engineering, both in porous and dense ceramic forms. The current review focusses on the various applications of dense hydroxyapatite and other dense biomaterials on the aspects of transparency and the mechanical and electrical behavior. Prospective future applications, established along the aforesaid applications of hydroxyapatite, appear to be promising regarding bone bonding, advanced medical treatment methods, improvement of the mechanical strength of artificial bone grafts and better in vitro/in vivo methodologies to afford more particular outcomes.

The powerful functions of peptide-based bioactive matrices for regenerative medicine

In an effort to develop bioactive matrices for regenerative medicine, peptides have been used widely to promote interactions with cells and elicit desired behaviors in vivo. This paper describes strategies that utilize peptide-based molecules as building blocks to create supramolecular nanostructures that emulate not only the architecture but also the chemistry of the extracellular matrix in mammalian biology. After initiating a desired regenerative response in vivo, the innate biodegradability of these systems allow for the natural biological processes to take over in order to promote formation of a new tissue without leaving a trace of the nonnatural components. These bioactive matrices can either bind or mimic growth factors or other protein ligands to elicit a cellular response, promote specific mechano-biological responses, and also guide the migration of cells with programmed directionality. In vivo applications discussed in this review using peptide-based matrices include the regeneration of axons after spinal cord injury, regeneration of bone, and the formation of blood vessels in ischemic muscle as a therapy in peripheral arterial disease and cardiovascular diseases.

High-performance silica nanoparticle reinforced poly (vinyl alcohol) as templates for bioactive nanocomposites

Silica nanoparticle reinforced poly (vinyl alcohol) cast sheets 40 μm thick were tested for mechanical and biological properties. The films were characterized using X-ray diffraction, scanning electron microscopy, and infrared spectroscopy. The crystallinity decreased with increased silica content. Changes in the morphology and structure upon the addition of silica suggest the formation of cross-linking. The modulus increased from 300 MPa for PVA to 7.2 GPa for 120 wt.% silica nanoparticle in the blend and the tensile strength increased from 3.5 MPa to 35 MPa. The modulus estimated using dynamic tests, tensile tests, and nanoindentation was comparable and was predicted well using the Halpin-Tsai's equation. The nanocomposites were an order of magnitude tougher than the pure polymer. Silica based nanocomposite was also found to be an excellent template for the deposition of calcium hydroxyapatite when immersed in simulated body fluid. The modulus and tensile strength of apatite coated silica nanoparticle (120 wt.%)-PVA composite increased to 11 GPa and 65 MPa respectively, close to that of cortical bone. The results represent one of the largest increases in mechanical properties of nanocomposite mimicking the properties of human bone. The addition of silica can also aid in osseointegration.

Self-Assembly for the Synthesis of Functional Biomaterials

The use of self-assembly for the construction of functional biomaterials is a highly promising and exciting area of research, with great potential for the treatment of injury or disease. By using multiple noncovalent interactions, coded into the molecular design of the constituent components, self-assembly allows for the construction of complex, adaptable, and highly tunable materials with potent biological effects. This review describes some of the seminal advances in the use of self-assembly to make novel systems for regenerative medicine and biology. Materials based on peptides, proteins, DNA, or hybrids thereof have found application in the treatment of a wide range of injuries and diseases, and this review outlines the design principles and practical applications of these systems. Most of the examples covered focus on the synthesis of hydrogels for the scaffolding or transplantation of cells, with an emphasis on the biological, mechanical, and structural properties of the resulting materials. In addition, we will discuss the distinct advantages conferred by self-assembly (compared with traditional covalent materials), and present some of the challenges and opportunities for the next generation of self-assembled biomaterials.

Bone regeneration with low dose BMP-2 amplified by biomimetic supramolecular nanofibers within collagen scaffolds

Bone morphogenetic protein-2 (BMP-2) is a potent osteoinductive cytokine that plays a critical role during bone regeneration and repair. In the extracellular environment, sulfated polysaccharides anchored covalently to glycoproteins such as syndecan and also non-covalently to fibronectin fibers have been shown to bind BMP-2 through a heparin-binding domain and regulate its bioactivity. We report here on a synthetic biomimetic strategy that emulates biological BMP-2 signaling through the use of peptide amphiphile nanofibers designed to bind heparin. The supramolecular nanofibers, which integrate the biological role of syndecan and fibronectin, were allowed to form gel networks within the pores of an absorbable collagen scaffold by simply infiltrating dilute solutions of the peptide amphiphile, heparan sulfate, and BMP-2. The hybrid biomaterial enhanced significantly bone regeneration in a rat critical-size femoral defect model using BMP-2 amounts that are one order of magnitude lower than required for healing in this animal model. Using micro-computed tomography, we also showed that the hybrid scaffold was more effective at bridging within the gap relative to a conventional scaffold of the type used clinically based on collagen and BMP-2. Histological evaluation also revealed the presence of more mature bone in the new ossified tissue when the low dose of BMP-2 was delivered using the biomimetic supramolecular system. These results demonstrate how molecularly designed materials that mimic features of the extracellular environment can amplify the regenerative capacity of growth factors.

The role of nanoscale architecture in supramolecular templating of biomimetic hydroxyapatite mineralization

Understanding and mimicking the hierarchical structure of mineralized tissue is a challenge in the field of biomineralization and is important for the development of scaffolds to guide bone regeneration. Bone is a remarkable tissue with an organic matrix comprised of aligned collagen bundles embedded with nanometer-sized inorganic hydroxyapatite (HAP) crystals that exhibit orientation on the macroscale. Hybrid organic-inorganic structures mimic the composition of mineralized tissue for functional bone scaffolds, but the relationship between morphology of the organic matrix and orientation of mineral is poorly understood. Herein the mineralization of supramolecular peptide amphiphile templates, that are designed to vary in nanoscale morphology by altering the amino acid sequence, is reported. It is found that 1D cylindrical nanostructures direct the growth of oriented HAP crystals, while flatter nanostructures fail to guide the orientation found in biological systems. The geometric constraints associated with the morphology of the nanostructures may effectively control HAP nucleation and growth. Additionally, the mineralization of macroscopically aligned bundles of the nanoscale assemblies to create hierarchically ordered scaffolds is explored. Again, it is found that only aligned gel templates of cylindrical nanostructures lead to hierarchical control over hydroxyapatite orientation across multiple length scales as found in bone.

Mineralization of peptide amphiphile nanofibers and its effect on the differentiation of human mesenchymal stem cells

One of the important targets in regenerative medicine is to design resorbable materials that can promote formation of new bone in large skeletal defects. One approach to this challenge is to use a bioactive and biodegradable organic matrix that can promote cellular adhesion and direct differentiation. We have here studied matrices composed of peptide amphiphiles (PAs) that self-assemble into nanofibers and create self-supporting gels under cell culture conditions. The bioactivity of PAs was designed by incorporating in their peptide sequences phosphoserine residues, to promote hydroxyapatite formation in the culture medium, and the cell adhesion epitope RGDS. In osteogenic medium supplemented with calcium the PA nanofibers were found to nucleate spheroidal nanoparticles of crystalline carbonated hydroxyapatite approximately 100 nm in diameter. This mineralization mode is not epitaxial relative to the long axis of the nanofibers and occurs in the presence of serine or phosphoserine residues in the peptide sequence of the amphiphiles. Mixing of the phosphoserine-containing PAs with 5 wt.% RGDS-containing PA molecules does not inhibit formation of the mineral nanoparticles. Quantitative real time reverse transcription polymerase chain reaction and immunohistochemistry analysis for alkaline phosphatase (ALP) and osteopontin expression suggest that these mineralized matrices promote osteogenic differentiation of human mesenchymal stem cells. Based on ALP expression, the presence of phosphoserine residues in PA nanofibers seems to favor osteogenic differentiation.

Recent advances in research applications of nanophase hydroxyapatite

Hydroxyapatite, the main inorganic material in natural bone, has been used widely for orthopaedic applications. Due to size effects and surface phenomena at the nanoscale, nanophase hydroxyapatite possesses unique properties compared to its bulk-phase counterpart. The high surface-to-volume ratio, reactivities, and biomimetic morphologies make nano-hydroxyapatite more favourable in applications such as orthopaedic implant coating or bone substitute filler. Recently, more efforts have been focused on the possibility of combining hydroxyapatite with other drugs and materials for multipurpose applications, such as antimicrobial treatments, osteoporosis treatments and magnetic manipulation. To build more effective nano-hydroxyapatite and composite systems, the particle synthesis processes, chemistry, and toxicity have to be thoroughly investigated. In this Minireview, we report the recent advances in research regarding nano-hydroxyapatite. Synthesis routes and a wide range of applications of hydroxyapatite nanoparticles will be discussed. The Minireview also addresses several challenges concerning the biosafety of the nanoparticles.

Evaluation of nano-biphasic calcium phosphate ceramics for bone tissue engineering applications: in vitro and preliminary in vivo studies

Reconstruction of critical sized bone injuries is a major problem that continues to inspire the design of new materials and grafts. Natural ceramics (hydroxyapatite (HA) coralline HA, or synthetic HA) and β-tricalcium phosphate (β-TCP) are being explored for use as scaffolds in bone tissue engineering, among several other materials. The present study evaluated the bone forming capacity of nanosize bioceramics synthesized in situ in poly-vinyl alcohol (PVA) with different ratios of HA and β-TCP; the Ca/P ratio was 1.62 for bioceramic P1, 1.60 for P2 and 1.58 for P3. Further osteogenesis in vitro with mesenchymal stem cells (MSC) acquired from different sources for osteogenesis in vitro and their bone healing properties in vivo were also evaluated. MSC isolated from human placenta, Wharton's jelly from umbilical cord, fetal bone marrow and adipose tissue, cultured in the presence of nanosize bioceramic particles, were monitored for osteogenic differentiation. Placental cells showed the best osteogenic potential of the different MSC studied on the basis of expression of osteogenic markers. Complete regeneration of the damaged region was observed in vivo when MSC derived from placenta were used with nanoceramic (Ca/P ratio 1.58) in the experimental defect created in the femur of Wistar rats. Even small variation in the Ca/P ratio can alter the outcome of tissue constructs.

Peptide Self-Assembly for Crafting Functional Biological Materials

Self-assembling, peptide-based scaffolds are frontrunners in the search for biomaterials with widespread impact in regenerative medicine. The inherent biocompatibility and cell signaling capabilities of peptides, in combination with control of secondary structure, has led to the development of a broad range of functional materials with potential for many novel therapies. More recently, membranes formed through complexation of peptide nanostructures with natural biopolymers have led to the development of hierarchically-structured constructs with potentially far-reaching applications in biology and medicine. In this review, we highlight recent advances in peptide-based gels and membranes, including work from our group and others. Specifically, we discuss the application of peptide-based materials in the regeneration of bone and enamel, cartilage, and the central nervous system, as well as the transplantation of islets, wound-healing, cardiovascular therapies, and treatment of erectile dysfunction after prostatectomy.

Prospects of Nanobiomaterials for Biosensing

Progress and development in biosensor development will inevitably focus upon the technology of the nanomaterials that offer promise to solve the biocompatibility and biofouling problems. The biosensors using smart nanomaterials have applications for rapid, specific, sensitive, inexpensive, in-field, on-line and/or real-time detection of pesticides, antibiotics, pathogens, toxins, proteins, microbes, plants, animals, foods, soil, air, and water. Thus, biosensors are excellent analytical tools for pollution monitoring, by which implementation of legislative provisions to safeguard our biosphere could be made effectively plausible. The current trends and challenges with nanomaterials for various applications will have focus biosensor development and miniaturization. All these growing areas will have a remarkable influence on the development of new ultrasensitive biosensing devices to resolve the severe pollution problems in the future that not only challenges the human health but also affects adversely other various comforts to living entities. This review paper summarizes recent progress in the development of biosensors by integrating functional biomolecules with different types of nanomaterials, including metallic nanoparticles, semiconductor nanoparticles, magnetic nanoparticles, inorganic/organic hybrid, dendrimers, and carbon nanotubes/graphene.

Volumetric analysis of osteoclastic bioresorption of calcium phosphate ceramics with different solubilities

Commonly, to determine osteoclastic resorption of biomaterials only the resorbed area is measured. The depth of the resorption pit, however, may also be important for the performance of a material. To generate such data we used two calcium phosphate ceramics (Ca(10) and Ca(2)). The solubility of the materials was determined according to DIN EN ISO 10993-14. They were scanned three-dimensionally using infinite focus microscopy and subsequently cultivated for 4 weeks in simulated body fluid without (control) or with human osteoclasts. After this cultivation period osteoclasts number was determined and surface changes were evaluated two- and three-dimensionally. Ca(10) and Ca(2) showed solubilities of 11.0+/-0.5 and 23.0+/-2.2 mgg(-1), respectively. Both materials induced a significant increase in osteoclast number. While Ca(10) did not show osteoclastic resorption, Ca(2) showed an increased pit area and pit volume due to osteoclastic action. This was caused by an increased average pit depth and an increased number of pits, while the average area of single pits did not change significantly. The deduced volumetric osteoclastic resorption rate (vORR) of Ca(2) (0.01-0.02 microm(3)microm(-2)day(-1)) was lower than the remodelling speed observed in vivo (0.08 microm(3)microm(-2)day(-1)), which is in line with the observation that implanted resorbable materials remain in the body longer than originally expected. Determination of volumetric indices of osteoclastic resorption might be valuable in obtaining additional information about cellular resorption of bone substitute materials. This may help facilitate the development of novel materials for bone substitution.

Bone regeneration mediated by biomimetic mineralization of a nanofiber matrix

Rapid bone regeneration within a three-dimensional defect without the use of bone grafts, exogenous growth factors, or cells remains a major challenge. We report here on the use of self-assembling peptide nanostructured gels to promote bone regeneration that have the capacity to mineralize in biomimetic fashion. The main molecular design was the use of phosphoserine residues in the sequence of a peptide amphiphile known to nucleate hydroxyapatite crystals on the surfaces of nanofibers. We tested the system in a rat femoral critical-size defect by placing pre-assembled nanofiber gels in a 5mm gap and analyzed bone formation with micro-computed tomography and histology. We found within 4 weeks significantly higher bone formation relative to controls lacking phosphorylated residues and comparable bone formation to that observed in animals treated with a clinically used allogenic bone matrix.

Nanotechnology applications and approaches for neuroregeneration and drug delivery to the central nervous system

Nanotechnology is the science and engineering concerned with the design, synthesis, and characterization of materials and devices that have a functional organization in at least one dimension on the nanometer (i.e., one billionth of a meter) scale. The potential impact of bottom up self-assembling nanotechnology, custom made molecules that self-assemble or self-organize into higher ordered structures in response to a defined chemical or physical cue, and top down lithographic type technologies where detail is engineered at smaller scales starting from bulk materials, stems from the fact that these nanoengineered materials and devices exhibit emergent mesocale and macroscale chemical and physical properties that are often different than their constituent nanoscale building block molecules or materials. As such, applications of nanotechnology to medicine and biology allow the interaction and integration of cells and tissues with nanoengineered substrates at a molecular (i.e., subcellular) level with a very high degree of functional specificity and control. This review considers applications of nanotechnology aimed at the neuroprotection and functional regeneration of the central nervous system (CNS) following traumatic or degenerative insults, and nanotechnology approaches for delivering drugs and other small molecules across the blood-brain barrier. It also discusses developing platform technologies that may prove to have broad applications to medicine and physiology, including some being developed for rescuing or replacing anatomical and/or functional CNS structures.

Nanosized and nanocrystalline calcium orthophosphates

Recent developments in biomineralization have already demonstrated that nanosized crystals and particles play an important role in the formation of hard tissues of animals. Namely, it is well established that the basic inorganic building blocks of bones and teeth of mammals are nanosized and nanocrystalline calcium orthophosphates in the form of apatites. In mammals, tens to hundreds nanocrystals of a biological apatite have been found to be combined into self-assembled structures under the control of bioorganic matrixes. Therefore, application and prospective use of the nanosized and nanocrystalline calcium orthophosphates for a clinical repair of damaged bones and teeth are also well known. For example, greater viability and better proliferation of various types of cells have been detected on smaller crystals of calcium orthophosphates. Thus, the nanosized and nanocrystalline forms of calcium orthophosphates have great potential to revolutionize the hard tissue-engineering field, starting from bone repair and augmentation to controlled drug delivery systems. This paper reviews the current state of art and recent developments of various nanosized and nanocrystalline calcium orthophosphates, starting from synthesis and characterization to biomedical and clinical applications. The review also provides possible directions for future research and development.

Nanodimensional and Nanocrystalline Apatites and Other Calcium Orthophosphates in Biomedical Engineering, Biology and Medicine

Recent developments in biomineralization have already demonstrated that nanosized particles play an important role in the formation of hard tissues of animals. Namely, the basic inorganic building blocks of bones and teeth of mammals are nanodimensional and nanocrystalline calcium orthophosphates (in the form of apatites) of a biological origin. In mammals, tens to hundreds nanocrystals of a biological apatite were found to be combined into self-assembled structures under the control of various bioorganic matrixes. In addition, the structures of both dental enamel and bones could be mimicked by an oriented aggregation of nanosized calcium orthophosphates, determined by the biomolecules. The application and prospective use of nanodimensional and nanocrystalline calcium orthophosphates for a clinical repair of damaged bones and teeth are also known. For example, a greater viability and a better proliferation of various types of cells were detected on smaller crystals of calcium orthophosphates. Thus, the nanodimensional and nanocrystalline forms of calcium orthophosphates have a great potential to revolutionize the field of hard tissue engineering starting from bone repair and augmentation to the controlled drug delivery devices. This paper reviews current state of knowledge and recent developments of this subject starting from the synthesis and characterization to biomedical and clinical applications. More to the point, this review provides possible directions of future research and development.

Differentiation of activated monocytes into osteoclast-like cells on a hydroxyapatite substrate: an in vitro study

BACKGROUND

Hydroxyapatite surface coatings of dental implants have been introduced to obtain more rapid and complete osteointegration. A possible complication associated with hydroxyapatite implant surface is the release of particles. Those particles may be phagocytosed by monocytes, the first cells to colonize the inflammatory sites. The activated monocytes produce cytokines that could cause osteoclast activation.

METHODOLOGY

In order to establish the biological effect of particles released on monocyte differentiation to an osteoclast phenotype, we have used the murine monocyte/macrophage cell line, RAW 264.7 clone CRL-2278 cultured on a hydroxyapatite substrate. The direct action of hydroxyapatite on monocyte differentiation was examined using tartrate-resistant acid phosphatase (TRAP), immunohistochemistry and transmission electron microscopy (TEM) and Western Blot analysis.

RESULTS

The present study demonstrated that hydroxyapatite substrate might be able to induce a self-production of RANKL cytokine that directly stimulates a different behaviour in terms of phenotype expression from monocyte/macrophage lineage to mature and functional osteoclasts without the addition of exogenous factors.

CONCLUSIONS

These studies were designed to test a model in which osteoclasts could be formed from HA-activated monocytes via positive feedback elicited by RANKL, allowing for identification of innovative targets for therapeutic approaches.

Enzyme Directed Templating of Artificial Bone Mineral

Bone is one of Nature's most remarkable materials, not only for its mechanical properties but also for its ability to repair fractures and remodel its microstructure in response to stress. At the nanoscale bone is a supramolecular matrix of collagen fibers reinforced by hydroxyapatite crystals with a high degree of order. Emulating elements of the biological synthesis of this composite could help develop strategies for advanced materials. Previous work has demonstrated the use of functionalized peptide amphiphile nanofibers in a two-dimensional system to emulate hydroxyapatite mineralization in natural bone. We describe here an artificial, in vitro biomineralization process that allows a similar process to occur in three dimensions. The system employs the natural enzyme alkaline phosphatase and a phosphorylated, anionic nanofiber gel matrix to template hydroxyapatite nanocrystals with size, shape, and crystallographic orientation resembling natural bone mineral. The formation of this biomimetic mineral in three dimensions results from the synergy of fiber-induced nucleation and the temporal control of phosphate ion harvesting by the enzyme. Gradual enzymatic harvesting of ions for crystal growth and the strong nucleating ability of the phosphorylated fibers suppresses uncontrolled precipitation of mineral. The strategy could lead to biomimetic materials to promote bone regeneration or the synthesis of hybrid materials with crystallographically defined structures.

A new rhenanite (β-NaCaPO4) and hydroxyapatite biphasic biomaterial for skeletal repair

Biphasic beta-rhenanite (beta-NaCaPO(4))-hydroxyapatite (Ca(10)(PO(4))(6)(OH)(2)) biomaterials were prepared by using a one-pot, solution-based synthesis procedure at the physiological pH of 7.4, followed by low-temperature (300-600 degrees C) calcination in air for 6 h. Calcination was for the sole purpose of crystallization. An aqueous solution of Ca(NO(3))(2). 4H(2)O was rapidly added to a solution of Na(2)HPO(4) and NaHCO(3), followed by immediate removal of gel-like, poorly-crystallized precursor precipitates from the mother liquors of pH 7.4. Freeze-dried precursors were found to be nanosize with an average particle size of 45 nm and a surface area of 128 m(2)/g. Upon calcination in air, precursor powders crystallized into biphasic (60% HA-40% rhenanite) biomaterials, while retaining their submicron particle sizes and high surface areas. beta-rhenanite is a high solubility sodium calcium phosphate phase. Samples were characterized by XRD, FTIR, SEM, TEM, ICP-AES, TG, DTA, DSC, and surface area measurements.

Surface properties of various powdered hydroxyapatites

Electrophoretic mobilities of various synthetic and semisynthetic hydroxyapatites (Ca10(PO4)6(OH)2, HAP) suspended in aqueous solutions have been measured as a function of pH and calcium concentration. The studied powders differ in particle size, crystallinity degree and surface contamination (carbonate). When equilibrated in mineral acids or bases, a large plateau of negative mobility is observed in the pH range 5-8, with increasing negative values at higher pH. Only in the case of the sample composed of nanoparticles, positive mobility obtains at pH < 8.9. When Ca2+ is added, positive mobility values are observed for all samples, and a bell-shaped profile results as a function of pH. Two possible models are explored to describe the results: the Nernstian approach, which assumes solubility equilibrium and surface potentials determined by the three potential-determining ions (Ca2+, PO3-4, and OH-), and the surface complexation approach, based on the idea of negligible phase transfer of structural phosphate. The Nernstian model is inadequate, whereas a very simple surface complexation model based on the equations Ca5(PO4)+3 = Ca4(PO4)-3 + Ca2+,Ca4(PO4)-3 + H+ = Ca4(PO4)2(PO4H),Ca5(PO4)+3 + OH- = Ca5(PO4)3(OH),coupled with a very simple electrical double layer, model suffices to reproduce the bell-shaped profile of the mobility as a function of pH in the presence of added calcium salts. The results also show that the sample composed of nanoparticles exchanges ions more easily with the solution, without reaching the solubility equilibrium in the explored timespans. In the presence of soluble phosphate salts, it is postulated that the same surface ensembles define the surface charge, with participation of phosphate as described by the equation Ca5(PO4)+3 + PO3-4 = Ca4(PO4)-3.HAP is just one member of a family of calcium phosphates with different (Ca)/(P) ratios. Electrophoretic mobilities of another member, tricalcium diphosphate, Ca3(PO4)2, were also measured and shown to be described by the same basic model. Comparison with previous literature data shows that the negative plateau in the mobility is a general feature of many HAP samples at low Ca2+, again in agreement with the surface complexation model. FTIR data demonstrates that surface phosphate indeed undergoes protonation, as postulated in the model.

Nanotechnology approaches for the regeneration and neuroprotection of the central nervous system

Nanotechnology is the science and engineering concerned with the design, synthesis, and characterization of materials and devices that have a functional organization in at least 1 dimension on the nanometer (ie, one-billionth of a meter) scale. The ability to manipulate and control engineered self-assembling (ie, self-organizing) substrates at these scales produces macroscopic physical and/or chemical properties in the bulk material not possessed by the constituent building block molecules alone. This in turn results in a degree of functional integration between the engineered substrates and cellular or physiological systems not previously attainable. Applied nanotechnology aimed at the regeneration and neuroprotection of the central nervous system (CNS) will significantly benefit from basic nanotechnology research conducted in parallel with advances in cell biology, neurophysiology, and neuropathology. Ultimately the goal is to develop novel technologies that directly or indirectly aid in providing neuroprotection and/or a permissive environment and active signaling cues for guided axon growth. In some cases, it is expected that the neurosurgeon will be required to administer these substrates to the patient. As such, in order for nanotechnology applications directed toward neurological disorders to develop to their fullest potential, it will be important for neuroscientists, neurosurgeons, and neurologists to participate and contribute to the scientific process alongside physical science and engineering colleagues. This review will focus on emerging clinical applications aimed at the regeneration and neuroprotection of the injured CNS, and discuss other platform technologies that have a significant potential for being adapted for clinical neuroscience applications.

Bone Morphogenetic Protein 2 and Retinoic Acid Acceleratein VivoBone Formation, Osteoclast Recruitment, and Bone Turnover

Reconstruction of craniofacial defects presents a substantial biomedical burden, and requires complex surgery. Interestingly, children after age 2 years and adults are unable to heal large skull defects. This nonhealing paradigm provides an excellent model system for craniofacial skeletal tissueengineering strategies. Previous studies have documented the in vivo osteogenic potential of adipose-derived stromal (ADS) cells and bone marrow-derived stromal (BMS) cells. This study investigates the ability to accelerate in vivo osteogenesis on ex vivo recombinant human bone morphogenetic protein 2 (BMP-2) and retinoic acid stimulation. Mouse osteoblasts, ADS cells, and BMS cells were seeded onto apatite-coated PLGA scaffolds, stimulated with rhBMP-2 and retinoic acid ex vivo for 4 weeks, and subsequently implanted into critically sized (4 mm) calvarial defects. Samples were harvested after 2, 4, 8, and 12 weeks. Areas of complete bony bridging were noted as early as 2 weeks in vivo; however, osteoclasts were attracted to the scaffold as identified by calcitonin receptor staining and tartrate-resistant acid phosphatase activity staining. Although the optimal method of in vitro osteogenic priming for mesenchymal cells remains unknown, these results provide evidence that BMP-2 and retinoic acid stimulation of multipotent cells ex vivo can subsequently induce significant quantities of bone formation within a short time period in vivo.

In vivo mechanisms of hydroxyapatite ceramic degradation by osteoclasts: fine structural microscopy

In the present study the in vivo mechanism of calcium-phosphate (CaP) ceramic degradation has been investigated by means of transmission electron microscopy. The results revealed osteoclast-mediated degradation of hydroxyapatite ceramic implanted into sheep bone by simultaneous resorption and phagocytosis. After 6 weeks of implantation, osteoclasts were localized immediately beneath the ceramic surface. They had formed resorption lacunae and exhibited typical ultrastructural features, such as the ruffled border, the clear zone, and the dorsal microvilli. Their resorption capacity also had become evident by alterations of the electron density and the shape of the CaP crystals localized within the acidic microenvironment of the ruffled border. Moreover, the osteoclasts simultaneously were capable of phagocytosing the resorbed CaP crystals. The formation of endophagosomes was performed (1) by the uptake of particles into large intracellular vacuoles, which were generated by deep invagination of the membranes of the osteoclastic ruffled border, and (2) by the encircling of particles due to the development of pseudopodia-like plasmaprotrusions of the ruffled border. The formation of endophagosomes was followed by the in situ fragmentation of the inclusion material, which subsequently was released into the extracellular space and phagocytosed by macrophages.

Ultrastructure of ceramic-bone interface using hydroxyapatite and beta-tricalcium phosphate ceramics and replacement mechanism of beta-tricalcium phosphate in bone

Hydroxyapatite (HA) and beta-tricalcium phosphate (beta-TCP) are useful for grafting and augmentation of bone tissue. Observation by transmission electron microscopy (TEM) was done to investigate the ultrastructures at the interfaces between the biomaterials and the adjacent tissue, and osteogenesis around the biomaterials in the present study. HA and beta-TCP ceramics were used in disk forms which had macropores and micropores, and were implanted between the parietal bone and the cranial periosteum of rats. Specimens were prepared for observation at 4 and 8 weeks postoperatively. The microscopic results indicated that an intervening layer was present on the surface of HA, whereas it was not present on the surface of beta-TCP. A characteristic fibrillar structure was observed in the intervening layer between HA and bone under decalcification by HCl. In beta-TCP, in reticular structures observed close to the bone tissue by optical microscopy, calcification and sparse collagen fibers were interspersed among the granules of beta-TCP. In addition, close to the interface between beta-TCP and bone, many osteocytes with numerous processes were present. Some processes were elongated towards the interface. These results revealed the difference in the ultrastructures of the interfaces between HA and beta-TCP, and the dissolution mechanism of beta-TCP in bone.

Evaluation of an in situ setting injectable calcium phosphate as a new carrier material for gentamicin in the treatment of chronic osteomyelitis: Studies in vitro and in vivo

A study was performed to investigate the effectiveness of hydroxyapatite cement (HAC) as a new carrier system in the treatment of chronic, posttraumatic osteomyelitis. In the in vitro study, release of gentamicin from standard cylinders of HAC were measured by agar diffusion test. As a representative for mechanical properties, compression strength was measured in order to detect changes when mixing HAC with gentamicin. In the in vivo study, bone infection was induced according to the model of Norden by injection of 1 ml Na-morrhuat and 3 x 10(6)CFU Staphylococcus aureus. After 3 weeks, when chronic stage of infection was obtained, 17 animals were treated by debridement and filling the marrow either with HAC alone or HAC mixed with gentamicin (32 mg/g). Animals of the control groups were left untreated. After 6 weeks, all animals were sacrificed. Hematological, radiological, microbiological and histological examinations were carried out by covered investigation. Best evidence of the efficiency of treatment was observed in histopathological and microbiological findings. In all swabs of the control groups, taken 6 weeks following infection S. aureus were detected which were clonal to the strain used for induction of osteomyelitis. In HAC/gentamicin-treated animals, no growth was detectable after 7 days of culturing in BHI bouillon. In the HAC/gentamicin-treated group, there was no histopathological evidence of infection. In all other groups different stages of chronic osteomyelitis were found. No side effect was observed, neither locally nor systemically by HAC or gentamicin. Therefore, HAC is considered to be a very effective carrier for antibiotics in treatment of chronic, posttraumatic osteomyelitis.

Development of multinuclear giant cells during the degradation of Bioglass® particles in rabbits

Bioglass particles of the compositions 45s5, 52s, and 55s were implanted in the distal femoral epiphysis of rabbits. Animals were sacrificed at 7, 28, and 84 days postoperatively and specimens investigated using electron microscopy and electron dispersive X-ray analysis. The intention was to correlate the finding of different types of multinuclear giant cells (MNGC) in the center of the implantation bed with earlier hypothesized accumulated particle eluates and changed particle compositions. The distribution of Si, Na, Ca, P, O, S, and Cl throughout the implantation bed was analyzed. Bioglass particles degraded either in Si-rich remnants or in CaP-shells. MNGC of foreign body giant cell type in high numbers as well as of osteoclast-like type at later time intervals in small numbers were found on the surface of Si-rich as well as on Ca- and P-rich particle remnants. Osteoclast-like cells were detected on the particles after transformation in CaP-shells. It is concluded that the formation of different types of MNGC is determined by the composition of the substrate, that is, osteoclast-like cells develop exclusively on resorbable substrates. The absolute number of MNGC depended on the time after implantation and the solubility of the implant. Bone bonding, however, only occurred on Ca- and P-rich surfaces.

Adipose-derived adult stromal cells heal critical-size mouse calvarial defects

In adults and children over two years of age, large cranial defects do not reossify successfully, posing a substantial biomedical burden. The osteogenic potential of bone marrow stromal (BMS) cells has been documented. This study investigates the in vivo osteogenic capability of adipose-derived adult stromal (ADAS) cells, BMS cells, calvarial-derived osteoblasts and dura mater cells to heal critical-size mouse calvarial defects. Implanted, apatite-coated, PLGA scaffolds seeded with ADAS or BMS cells produced significant intramembranous bone formation by 2 weeks and areas of complete bony bridging by 12 weeks as shown by X-ray analysis, histology and live micromolecular imaging. The contribution of implanted cells to new bone formation was 84-99% by chromosomal detection. These data show that ADAS cells heal critical-size skeletal defects without genetic manipulation or the addition of exogenous growth factors.

Preparation of hydroxyapatite-gelatin nanocomposite

A nanocomposite of gelatin[GEL]-hydroxyapatite[HAp] was prepared using the biomimetic process. The hydroxyapatite nanocrystals were precipitated in aqueous solution of gelatin at pH 8 and 38 degrees C. The chemical bonding between calcium ions of HAp and carboxyl ions of GEL molecules induced a red-shift of the 1339 cm(-1) band of GEL in FT-IR analysis. TEM images and electron diffraction patterns for the nanocomposite strongly indicate the self-organization of HAp nanocrystals along the GEL fibrils. Electron diffraction for the nanocomposites showed a strong preferred orientation of the (002) plane in HAp nanocrystals. The development of HAp nanocrystals in an aqueous GEL solution was highly influenced by the concentration ratio of GEL to HAp. A higher concentration of GEL induced the formation of tiny crystallites (4 nm x 9 nm size), while a lower concentration of GEL contributed to the development of bigger crystallites (30 nm x 70 nm size). From DT/TGA data, the HAp-GEL nanocomposite showed typically three exothermic temperatures. The increase in decomposition temperatures indicates the formation of a primary chemical bond between HAp and GEL. The higher concentration of GEL supplies abundant reaction sites containing groups such as carboxyl, which can bind with calcium ions. The abundant supply of reaction sites leads to a very large number of HAp nuclei. However, the formation of a large number of nuclei depletes the concentration of calcium ions that available for growth to the extent that the nuclei cannot grow very large. This in turn will lead to the creation of a large number of tiny nanocrystals at this higher GEL concentration.

Formation of bone-like apatite on poly(L-lactic acid) fibers by a biomimetic process

Bone-like apatite coating on poly(L-lactic acid) (PLLA) fibers was formed by immersing the fibers in a modified simulated body fluid (SBF) at 37 degrees C and pH 7.3 after hydrolysis of the fibers in water. The ion concentrations in SBF were nearly 1.5 times of those in the human blood plasma. The apatite was characterized by scanning electron microscopy (SEM) with energy dispersive X-ray spectroscopy (EDX), X-ray photoelectron spectroscopy (XPS), thin-film X-ray diffraction, and Fourier transform infrared spectroscopy. After 15 days of incubation in SBF, an apatite layer with about 5-6 microm thickness was formed on the surface of the fibers. This apatite had a Ca/P ratio similar to that of natural bone. The mass of apatite coated PLLA fibers increased with extending the incubation time. After 20 days incubation, the fibers increased their mass by 25.8 +/- 2.1%. The apatite coating had no significant effect on the tensile properties of PLLA fibers. In this article, the bone-like apatite coating on three-dimensional PLLA braids was also studied. The motivation for this apatite coating was that it might demonstrate enhanced osteoconductivity in the future studies when they serve as biodegradable scaffolds in tissue engineering.

Stability of the bone-implant complex. Results of longitudinal testing to 60 months with the Periotest device on endosseous dental implants

BACKGROUND

Maintenance of the health and integrity of the bone-implant complex (osseointegration) has been shown to be essential for long term success of root-form, endosseous dental implants. If reliable clinical indicators of adequacy of the bone-implant complex existed, they could stimulate new and innovative early intervention research to arrest of reverse early deterioration of the bone-implant complex. In the absence of such indicators, this has been problematic. The Periotest may have the potential to provide this information by indirectly assessing the status of the bone-implant complex. However, little information is available that documents either the capability of the Periotest to reliably assess changes of the bone-implant complex or the "normal variations" in Periotest values (PTVs) for both HA-coated and non-coated implants.

METHODS

The purpose of this paper was to document changes in PTVs as influenced by various implant surfaces, implant designs, and bone densities. The mean PTVs recorded for each visit, for all implant types and bone densities, were combined to provide an overall average PTV (A-PTV). The changes in stability (PTVs) were analyzed using a generalized linear model (GLM) with repeated measures (Hotelling's Trace).

RESULTS

The A-PTV for all implants over all visits was -3.5. The mean PTVs ranged from -4.2 (SD = 2.4) at uncovering to -3.9 (SD = 2.9) at 60 months. All implants in bone qualities 1 and 2 (BQ-1 and BQ-2) became more stable over time, while those in bone quality 3 or 4 (BQ-3 and BQ-4) showed a slight decrease in stability. In BQ-1, the mean PTVs increased from -4.7 at uncovering to -4.9 at 60 months. A similar increase in stability occurred in BQ-2 (-4.1 at uncovering to -4.4 at 60 months). In BQ-3, the stability of the implants decreased over time (-3.6 at uncovering to -2.9 at 60 months), with similar changes recorded for BQ-4 (-2.5 at uncovering to -1.0 at 60 months). When comparing the stability of all HA-coated with all non-coated implants, the HA implants became less stable (-4.4 to -3.4) over time, while non-coated implants showed an improvement in stability (-3.5 to -4.5). The changes in stability found in BQ-1, BQ-2, and BQ-3 were similar, with HA implants becoming less stable and non-coated more stable. HA- and non-coated comparisons were not possible in BQ-4 since there were too few non-coated implants placed in this type of bone. The HA-coated screw showed a decrease in stability when compared to the non-coated screw.

CONCLUSIONS

Conclusions of the study are as follows: 1) PTVs are influenced by bone quality and surface coating of the implant; 2) the PTVs at the time of uncovering provide the best estimate of a clinically acceptable PTV for that bone-implant complex; 3) while the PTVs for any bone-implant complex may fluctuate +/- 1.0 around the uncovering PTV during routine healing and loading of the implant, a consistent shift toward a positive PTV that approaches "0" should be cause for concern that the bone-implant complex may be at risk of failure; 4) HA-coated implants became slightly less stable (more positive PTVs) over time, while the non-coated implants became more stable (more negative PTVs); and 5) until a "critical PTV" can be accurately identified, it is suggested that a consistent shift in recorded PTVs that exceeds the +3.0 value on the PTV scale should be viewed with concern for possible deterioration at the bone-implant complex.

Formation of calcium phosphate/collagen composites through mineralization of collagen matrix

Several types of calcium phosphate/collagen composites, including noncrystalline calcium phosphate/collagen, poorly crystalline carbonate-apatite (PCCA)/collagen, and PCCA + tetracalcium phosphate/collagen composites, were prepared through the mineralization of collagen matrix. The type I collagen was presoaked with a PO(3-)(4) containing solution and then immersed in a Ca(2+) containing solution to allow mineral deposition. The solution of 0.56 M sodium dibasic phosphate (Na(2)HPO(4)) with a pH of nearly 14 was metastable and its crystallization produced Na(2)HPO(4) and sodium tripolyphosphate hexahydrate (Na(5)P(3)O(10)). 6H(2)O), leading to a controlled release of orthophosphate ions during the subsequent mineral precipitation. The development of the composites was investigated in detail. The mineral contributed up to 60-70% of the weight of the final composites. The strength and Young's modulus of the composites in tensile tests overlapped the lower range of values reported for bone. When implanted in muscle tissue, the composite showed biodegradability that was partly through a multinucleated giant cell mediated process. In a bone explant culture model it was observed that bone-derived cells deposited mineralizing collagenous matrix on the composite.

Tissue responses to natural aragonite (Margaritifera shell) implants in vivo

The purpose of this study was to access tissue reactions to the outer prismatic (prism) and the inner nacreous (nacre) layers of the fresh water Margaritifera shell. The materials, in granule form, were implanted into the back muscles and femurs of rats for 1, 2, 4, 8 and 16 weeks. In the back muscles, a foreign body reaction was observed around the implants, starting from one week after implantation and reaching maximal proportions at two weeks. After four weeks, a thin layer of fibrous tissue encapsulated the implanted particles. The external surface of the material stained strongly with acid fuchsin, indicating degradation of implant. At femoral sites, newly formed bone was directly applied to the implant surfaces. The outer-most parts of the organic sheets in prisms were not degraded until 16 weeks after implantation and were embedded in the newly formed bone. The interface between bone and the implants showed close fusion by scanning electron microscopy (SEM). Energy dispersive X-ray analysis (EDAX) demonstrated a phosphorous-rich zone in the interface between bone and the implants, and no electron-dense layer in the interface was found by transmission electron microscopy (TEM). We conclude that Margaritifera shells are biocompatible, biodegradable and osteoconductive materials. Bonding between this natural aragonite and bone seems to occur via a phosphorous-rich intermediate layer.

Organoapatite growth on an orthopedic alloy surface

We report here a method to coat orthopedic metals with the artificial bone material organoapatite. The growth of organoapatite on titanium alloy surfaces of foils and porous cylinders involves sequential preadsorption of poly(L-lysine) and poly(L-glutamic acid) on metal, followed by exposure to organoapatite-precipitating solutions. The organoapatite characterization of the coating was carried out by transmission electron microscopy, electron diffraction, scanning electron microscopy, energy-dispersive X-ray scattering, powder X-ray diffraction, FT-IR, and elemental analysis. The preadsorbed poly(amino acids) in the form of a self-assembled bilayer of oppositely charged macromolecules can lead to a surface coverage of titanium alloy in the range of 70-90%. The deposition mechanisms could involve the surface capture of embryonic crystals and the nucleation of apatite on the bilayer. Bioabsorbable organoapatite could serve as a tissue-engineering scaffold for bone regeneration into porous implants.

Characterization of the mechanical and ultrastructural properties of heat-treated cortical bone for use as a bone substitute

Heat-treated bovine cortical bone has been proposed as an alternative to bone grafts and synthetic bone substitutes because it may combine the advantages of allografts (high stiffness and strength) and synthetic materials (abundant supply, reduced risk of rejection and disease transfer). Its mechanical properties and ultrastructure, however, are not well characterized. To address this, we compared the compressive (n = 20, bovine bone) and tensile (n = 26, bovine bone) mechanical properties and the ultrastructure (n = 12, human bone) of intact versus 350 degrees C heat-treated cortical bone. The 350 degrees C heat-treated bone had a mean +/- SD elastic modulus similar to the intact bone for both compression (16.3 +/- 2.2 GPa, pooled; p = 0.68) and tension (16.3 +/- 3.7 GPa, pooled; p = 0.95). It also maintained 63% of the intact strength in compression but only 9% in tension (p < 0.001). Infrared scans and X-ray diffraction patterns showed no differences between the 350 degrees C heat-treated and intact bone but large differences between ashed (700 degrees C) and intact bone. Similarly, heat-treated bone previously has been shown to be biocompatible and osteoconductive. We conclude, therefore, that 350 degrees C heat-treated cortical bone may be an excellent load-bearing bone substitute provided that it is loaded in compression only in vivo and is shown by future work to have acceptable fatigue properties.

Tissue response to nano-hydroxyapatite/collagen composite implants in marrow cavity

The tissue response to a nano-hydroxyapatite/collagen composite implanted in a marrow cavity was investigated by histology and scanning electron microscopy. A Knoop microhardness test was performed to compare the mechanical behavior of the composite and bone. The ultrastructural features of the composite, especially the carbonate-substituted hydroxyapatite with low crystallinity and nanometer size, made it a bone-resembling material. It was bioactive, as well as biodegradable. At the interface of the implant and marrow tissue, solution-mediated dissolution and giant cell mediated resorption led to the degradation of the composite. Interfacial bone formation by osteoblasts was also evident. The process of implant degradation and bone substitution was reminiscent of bone remodeling. The composite can be incorporated into bone metabolism instead of being a permanent implant. For lack of the hierarchical organization similar to that of bone, the composite exhibited an isotropic mechanical behavior. However, the resistance of the composite to localized pressure could reach the lower limit of that of the femur compacta.

Nanocrystals of magnesium and fluoride substituted hydroxyapatite

Hydroxyapatite nanocrystals synthetized in the presence of different concentrations of magnesium and fluoride ions in solutions--1, 5 and 10 at.% have been submitted to a structural and chemical characterization. The syntheses were carried out in the presence of low molecular weight polyacrylic acid, which has been verified to inhibit hydroxyapatite crystallization. The polyelectrolyte is adsorbed into the crystals during the synthesis and provokes a reduction of the mean crystal sizes. The reduction is greater along the direction orthogonal to the c-axis, suggesting a preferential adsorption of the polyelectrolyte on the crystalline faces parallel to the c-axis. Both magnesium and fluoride can be incorporated into the hydroxyapatite structure. On the basis of the values of the lattice constants and of the magnesium relative content of the solid phase, it can be suggested that probably just a part of magnesium is substituted for calcium, the remainder being adsorbed on the crystal surface. However, magnesium destabilizes the apatitic structure favouring its thermal conversion into beta-tricalcium phosphate, and displays an inhibiting effect on the crystallization of hydroxyapatite. This last effect is enhanced by the simultaneous presence of polyacrylic acid. Fluoride substitution for hydroxyl ions into hydroxyapatite structure induces a slight increase of the crystal sizes along the c-axis direction. The data indicate that the experimental approach can be successfully used to prepare nanoapatite with crystallinity, crystal dimensions, composition, structure and stability very close to those characteristics of biological apatites.

Osteoblast reaction at the interface between surface-active materials and bone in vivo: a study using in situ hybridization

Osteoblast activation after implantation of two kinds of surface-active material in bone was investigated chronologically using in situ hybridization with digoxygenin-labeled procollagen alpha 1(I) complementary RNA probe. The bioactive materials used were hydroxyapatite (HA) and apatite- and wollastonite-containing glass-ceramic (A-W GC). A hole was drilled bilaterally in the distal epiphysis of rabbit femurs with subsequent implantation of HA or A-W GC cylinders in a press-fit manner. Specimens were collected at 3, 7, 14, and 28 days after operation and decalcified. Then the undecalcified implant cores were pushed out of the hole without causing damage to the bony side of the interface. In situ hybridization documented no qualitative differences in the expression of procollagen alpha 1(I) RNA between HA and A-W GC. Few osteoblasts at the bone-material interface showed a specific signal at day 3, whereas many osteoblasts were positive around the materials at days 7 and 14, indicative of active new bone formation. The positive osteoblasts seemed to originate from preexisting trabeculae and lined the trabeculae, newly formed bone, and material surface. At day 28, many osteoblasts lining material-surrounding bone were negative, whereas those in remodeling canals were positive, suggesting that the bone was in the remodeling stage after bone formation. These findings were comparable to those with beta-tricalcium phosphate in a previous study, thus suggesting osteoconductive bone formation on HA and A-W GC.