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Histological, Histomorphometrical, and Biomechanical Studies of Bone-Implanted Medical Devices: Hard Resin Embedding. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1804630. [PMID: 32420323 PMCID: PMC7201441 DOI: 10.1155/2020/1804630] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/25/2019] [Accepted: 12/09/2019] [Indexed: 11/17/2022]
Abstract
The growing incidence of degenerative musculoskeletal disorders as well as lifestyle changes has led to an increase in the surgical procedures involving implanted medical devices in orthopedics. When studying implant/tissue interface in hard materials (i.e., metals or dense plastics) and/or in large bone segments, the hard plastic embedding of the intact undecalcified tissue envelope with the implant in situ is needed. The aim of this work is to describe the advances and the possibilities of high-temperature methyl methacrylate (MMA) embedding for the histological, histomorphometrical, and biomechanical assessment of bone-implanted medical devices. Unlike routine techniques, undecalcified bone processing histology, using high-temperature MMA, requires a complex and precise sample processing methodology and the availability of sophisticated equipment and software for both sample preparation and analyses. MMA embedding permits the evaluation of biological responses to the presence of implanted medical devices without implant removal, allowing simultaneous qualitative and quantitative histological evaluation, both static and dynamic histomorphometry, and biomechanical analyses not possible with tissue decalcification. MMA embedding, despite being a demanding procedure, is still preferred to other kinds of resin-based embedding because of its peculiar characteristics, which allow the study of samples of big dimensions also implanted with hard materials without reducing the sample or removing the material. Dynamic measurements are allowed together with biomechanical investigations at the bone-biomaterial interface, obtaining a comprehensive and precise evaluation of the safety and effectiveness of medical devices for orthopedic regenerative, reconstructive, and reparative surgery.
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Suva LJ, Westhusin ME, Long CR, Gaddy D. Engineering bone phenotypes in domestic animals: Unique resources for enhancing musculoskeletal research. Bone 2020; 130:115119. [PMID: 31712131 PMCID: PMC8805042 DOI: 10.1016/j.bone.2019.115119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/16/2019] [Accepted: 10/21/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Larry J Suva
- Department of Veterinary Physiology and Pharmacology, College Station, TX, 77843, United States.
| | - Mark E Westhusin
- Department of Veterinary Physiology and Pharmacology, College Station, TX, 77843, United States
| | - Charles R Long
- Department of Veterinary Physiology and Pharmacology, College Station, TX, 77843, United States
| | - Dana Gaddy
- Department of Veterinary Integrative Biosciences Texas A&M University, College Station, TX 77843, United States
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Gvetadze RS, Dmitrieva NA, Voronin AN. [Adhesion of microorganisms to various dental materials used to form a gum contour in implant-retained restorations]. STOMATOLOGII︠A︡ 2019; 98:118-123. [PMID: 31701941 DOI: 10.17116/stomat201998051118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The article the literature review on dental materials for the manufacture of gum formers used in dental implantology. Adhesion of microorganisms to titanium, PMMA and PEEK resins is discussed. According to published studies PEEK polymer is characterized by a similar bacterial contamination compared to titanium but shows lower degree of contamination when compared to acrylic resins in equal conditions.
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Affiliation(s)
- R Sh Gvetadze
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - N A Dmitrieva
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - A N Voronin
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Kulakov AA, Kasparov AS, Porfenchuk DA. [Factors affecting osteointegration and the use of early functional load to reduce the duration of treatment in dental implantation]. STOMATOLOGIIA 2019; 98:107-115. [PMID: 31513161 DOI: 10.17116/stomat201998041107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The article presents literature data on the impact of the surface and shape of dental implants and early functional load with aesthetic and functional rehabilitation on osteointegration and stability of implants at various implantation terms.
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Affiliation(s)
- A A Kulakov
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - A S Kasparov
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - D A Porfenchuk
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Dereka X, Calciolari E, Donos N, Mardas N. Osseointegration in osteoporotic-like condition: A systematic review of preclinical studies. J Periodontal Res 2018; 53:933-940. [PMID: 29845622 DOI: 10.1111/jre.12566] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2018] [Indexed: 12/11/2022]
Abstract
Osteoporosis is one of the most common skeletal disorders affecting a significant percentage of people worldwide. Research data suggested that systemic diseases such as osteoporosis could act as risk factors for osseointegration, jeopardizing the healing process and thus the predictability of dental implant success on compromised patients. It is well accepted that preclinical studies in animal models reproducing the osteoporotic condition are one of the most important stages in the research of new biomaterials and therapeutic modalities. The aim of this systematic review was to investigate whether osteoporosis compromises dental implant osseointegration in experimental osteoporotic-like conditions. A 3-stage systematic literature research was conducted in MEDLINE via OVID and EMBASE up to and including March 2017. Experimental studies reporting on dental implant osseointegration on different osteoporotic animal models were assessed. The studies had to report on the percentage of bone-to-implant contact (%BIC) as the primary outcome. ARRIVE guidelines for reporting on animal research were applied to evaluate the methodological quality and risk of bias of the studies. Fifty-seven studies met the inclusion criteria and were assessed qualitatively. The most adopted animal model was the rat. A variability of %BIC values was observed, ranging from 30% to 99% and from 26% to 94% for the healthy and osteoporotic group, respectively. The great majority (47) of the included studies concluded that estrogen deficiency significantly affects BIC values, 9 studies stated that it was not possible to observe statistical differences in BIC between ovariectomized and healthy groups and 1 study did not provide a comparison between the healthy and osteoporotic group. Owing to the great heterogeneity in implant surface, study design, observation time-points, site of implant placement and reported outcomes, a meta-analysis could not be performed. An overall high risk of bias was observed, owing to the limited information on animal housing and husbandry, baseline characteristics and health status, ethical statement and allocation to the experimental groups provided. Although the available studies seem to suggest a lower osseointegration in osteoporotic-like conditions, no robust conclusions can be drawn due to the great heterogeneity and overall low quality of the available studies. Future studies with emphasis on minimizing the possible sources of bias and evaluating osseointegration of dental implants placed into jawbones instead of long bones are warranted.
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Affiliation(s)
- X Dereka
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - E Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - N Donos
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - N Mardas
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
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Orapiriyakul W, Young PS, Damiati L, Tsimbouri PM. Antibacterial surface modification of titanium implants in orthopaedics. J Tissue Eng 2018; 9:2041731418789838. [PMID: 30083308 PMCID: PMC6071164 DOI: 10.1177/2041731418789838] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 06/29/2018] [Indexed: 12/18/2022] Open
Abstract
The use of biomaterials in orthopaedics for joint replacement, fracture healing and bone regeneration is a rapidly expanding field. Infection of these biomaterials is a major healthcare burden, leading to significant morbidity and mortality. Furthermore, the cost to healthcare systems is increasing dramatically. With advances in implant design and production, research has predominately focussed on osseointegration; however, modification of implant material, surface topography and chemistry can also provide antibacterial activity. With the increasing burden of infection, it is vitally important that we consider the bacterial interaction with the biomaterial and the host when designing and manufacturing future implants. During this review, we will elucidate the interaction between patient, biomaterial surface and bacteria. We aim to review current and developing surface modifications with a view towards antibacterial orthopaedic implants for clinical applications.
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Affiliation(s)
- Wich Orapiriyakul
- Centre for the Cellular Microenvironment, College of Medical, Veterinary & Life Sciences, Institute of Molecular, Cell and Systems Biology, University of Glasgow, Glasgow, UK
| | - Peter S Young
- Centre for the Cellular Microenvironment, College of Medical, Veterinary & Life Sciences, Institute of Molecular, Cell and Systems Biology, University of Glasgow, Glasgow, UK
| | - Laila Damiati
- Centre for the Cellular Microenvironment, College of Medical, Veterinary & Life Sciences, Institute of Molecular, Cell and Systems Biology, University of Glasgow, Glasgow, UK
| | - Penelope M Tsimbouri
- Centre for the Cellular Microenvironment, College of Medical, Veterinary & Life Sciences, Institute of Molecular, Cell and Systems Biology, University of Glasgow, Glasgow, UK
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Role of Osteogenic Coatings on Implant Surfaces in Promoting Bone-To-Implant Contact in Experimental Osteoporosis: A Systematic Review and Meta-Analysis. IMPLANT DENT 2018; 26:770-777. [PMID: 28767464 DOI: 10.1097/id.0000000000000634] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis was to evaluate the role of osteogenic coatings (placement of a thin film of organic and inorganic osteoinductive and osteoproliferative materials) on implant surfaces in augmenting bone-to-implant contact (BIC) in osteoporotic bone. DATA SOURCES To answer the focused question "Do osteogenic coatings on implant surfaces increase BIC in osteoporotic bone?" PubMed/MEDLINE, EMBASE, ISI Web of Knowledge, Scopus, and Google-Scholar databases were searched till June 2017 using different combinations of the following key words: bone-to-implant contact, coating, implant surface, osseointegration, and osteoporosis. Letters to the Editor, review articles, case-reports/case-series, and commentaries were excluded. RESULTS Six animal studies were included, in which osteoporosis was induced by bilateral ovariectomy. In all studies, implant surface roughness was increased by various osteogenic surface coatings including alumina, hydroxyapatite, calcium phosphate, and zoledronic acid. Five studies showed that bone volume and BIC are significantly higher around implants with coated surfaces than noncoated implants. In 1 study, there was no difference in BIC around coated and noncoated implants. CONCLUSION Although experimental studies have shown that osteogenic coatings are effective in enhancing BIC, their clinical relevance requires further investigations.
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Dias IR, Camassa JA, Bordelo JA, Babo PS, Viegas CA, Dourado N, Reis RL, Gomes ME. Preclinical and Translational Studies in Small Ruminants (Sheep and Goat) as Models for Osteoporosis Research. Curr Osteoporos Rep 2018; 16:182-197. [PMID: 29460175 DOI: 10.1007/s11914-018-0431-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF THE REVIEW This review summarizes research on the use of sheep and goats as large animal models of human osteoporosis for preclinical and translational studies. RECENT FINDINGS The most frequent osteoporotic sheep model used is the ovariectomized sheep with 12 months post-operatively or more and the combined treatment of ovariectomized sheep associated to calcium/vitamin D-deficient diet and glucocorticoid applications for 6 months, but other methods are also described, like pinealectomy or hypothalamic-pituitary disconnection in ovariectomized sheep. The goat model for osteoporosis research has been used in a very limited number of studies in osteoporosis research relative to sheep. These osteoporotic small ruminant models are applied for biomaterial research, bone augmentation, efficacy of implant fixation, fragility fracture-healing process improvement, or bone-defect repair studies in the osteopenic or osteoporotic bone. Sheep are a recognized large animal model for preclinical and translational studies in osteoporosis research and the goat to a lesser extent. Recently, the pathophysiological mechanism underlying induction of osteoporosis in glucocorticoid-treated ovariectomized aged sheep was clarified, being similar to what occurs in postmenopausal women with glucocorticoid-induced osteoporosis. It was also concluded that the receptor activator of NF-κB ligand was stimulated in the late progressive phase of the osteoporosis induced by steroids in sheep. The knowledge of the pathophysiological mechanisms at the cellular and molecular levels of the induction of osteoporosis in small ruminants, if identical to humans, will allow in the future, the use of these animal models with greater confidence in the preclinical and translational studies for osteoporosis research.
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Affiliation(s)
- Isabel R Dias
- Department of Veterinary Sciences, Agricultural and Veterinary Sciences School, University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801, Vila Real, Portugal.
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Department of Polymer Engineering, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark-Parque da Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal.
- ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga, Portugal.
| | - José A Camassa
- Department of Veterinary Sciences, Agricultural and Veterinary Sciences School, University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801, Vila Real, Portugal
| | - João A Bordelo
- Department of Veterinary Sciences, Agricultural and Veterinary Sciences School, University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801, Vila Real, Portugal
| | - Pedro S Babo
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Department of Polymer Engineering, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark-Parque da Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga, Portugal
| | - Carlos A Viegas
- Department of Veterinary Sciences, Agricultural and Veterinary Sciences School, University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801, Vila Real, Portugal
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Department of Polymer Engineering, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark-Parque da Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga, Portugal
| | - Nuno Dourado
- CMEMS-UMinho, Department of Mechanical Engineering, University of Minho, Campus de Azurém, 4804-533, Guimarães, Portugal
| | - Rui L Reis
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Department of Polymer Engineering, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark-Parque da Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga, Portugal
| | - Manuela E Gomes
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Department of Polymer Engineering, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark-Parque da Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga, Portugal
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The GDF5 mutant BB-1 enhances the bone formation induced by an injectable, poly(l-lactide-co-glycolide) acid (PLGA) fiber-reinforced, brushite-forming cement in a sheep defect model of lumbar osteopenia. Spine J 2018; 18:357-369. [PMID: 29031993 DOI: 10.1016/j.spinee.2017.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 09/15/2017] [Accepted: 10/02/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Targeted delivery of osteoinductive bone morphogenetic proteins (eg, GDF5) in bioresorbable calcium phosphate cement (CPC), potentially suitable for vertebroplasty and kyphoplasty of osteoporotic vertebral fractures, may be required to counteract augmented local bone catabolism and to support complete bone regeneration. The biologically optimized GDF5 mutant BB-1 may represent an attractive drug candidate for this purpose. PURPOSE The aim of the current study was to test an injectable, poly(l-lactide-co-glycolide) acid (PLGA) fiber-reinforced, brushite-forming CPC containing low-dose BB-1 in a sheep lumbar osteopenia model. STUDY DESIGN/ SETTING This is a prospective experimental animal study. METHODS Bone defects (diameter 5 mm) were generated in aged, osteopenic female sheep and were filled with fiber-reinforced CPC alone (L4; CPC+fibers) or with CPC containing different dosages of BB-1 (L5; CPC+fibers+BB-1; 5, 100, and 500 µg BB-1; n=6 each). The results were compared with those of untouched controls (L1). Three and 9 months after the operation, structural and functional effects of the CPC (±BB-1) were analyzed ex vivo by measuring (1) bone mineral density (BMD); (2) bone structure, that is, bone volume/total volume (BV/TV) (assessed by micro-CT and histomorphometry), trabecular thickness (Tb.Th), and trabecular number (Tb.N); (3) bone formation, that is, osteoid volume/bone volume (OV/BV), osteoid surface/bone surface (OS/BS), osteoid thickness, mineralizing surface/bone surface (MS/BS), mineral apposition rate, and bone formation rate/bone surface; (4) bone resorption, that is, eroded surface/bone surface; and (5) compressive strength. RESULTS Compared with untouched controls (L1), CPC+fibers (L4) and/or CPC+fibers+BB-1 (L5) significantly improved all parameters of bone formation, bone resorption, and bone structure. These effects were observed at 3 and 9 months, but were less pronounced for some parameters at 9 months. Compared with CPC without BB-1, additional significant effects of BB-1 were demonstrated for BMD, bone structure (BV/TV, Tb.Th, and Tb.N), and bone formation (OS/BS and MS/BS). The BB-1 effects on bone formation at 3 and 9 months were dose dependent, with 100 µg as the potentially optimal dosage. CONCLUSIONS BB-1 significantly enhanced the bone formation induced by a PLGA fiber-reinforced CPC in sheep lumbar osteopenia. A single local dose as low as 100 µg BB-1 was sufficient to augment middle- to long-term bone formation. A CPC containing the novel GDF5 mutant BB-1 may thus represent an alternative to the bioinert, supraphysiologically stiff polymethylmethacrylate cement presently used to treat osteoporotic vertebral fractures by vertebroplasty and kyphoplasty.
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GDF5 significantly augments the bone formation induced by an injectable, PLGA fiber-reinforced, brushite-forming cement in a sheep defect model of lumbar osteopenia. Spine J 2017. [PMID: 28642196 DOI: 10.1016/j.spinee.2017.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Biodegradable calcium phosphate cement (CPC) represents a promising option for the surgical treatment of osteoporotic vertebral fractures. Because of augmented local bone catabolism, however, additional targeted delivery of bone morphogenetic proteins with the CPC may be needed to promote rapid and complete bone regeneration. PURPOSE In the present study, an injectable, poly(l-lactide-co-glycolide) acid (PLGA) fiber-reinforced, brushite-forming cement (CPC) containing the bone morphogenetic protein GDF5 was tested in a sheep lumbar osteopenia model. STUDY DESIGN/SETTING This is a prospective experimental animal study. METHODS Defined bone defects (diameter 5 mm) were placed in aged, osteopenic female sheep. Defects were treated with fiber-reinforced CPC alone (L4; CPC+fibers) or with CPC containing different dosages of GDF5 (L5; CPC+fibers+GDF5; 1, 5, 100, and 500 µg GDF5; n=5 or 6 each). The results were compared with those of untouched controls (L1). Three and 9 months postoperation, structural and functional effects of the CPC (±GDF5) were assessed ex vivo by measuring (1) bone mineral density (BMD); (2) bone structure, that is, bone volume/total volume (assessed by micro-computed tomography and histomorphometry), trabecular thickness, and trabecular number; (3) bone formation, that is, osteoid volume/bone volume, osteoid surface/bone surface, osteoid thickness, mineralized surface/bone surface, mineral apposition rate, and bone formation rate/bone surface; (4) bone resorption, that is, eroded surface/bone surface; and (5) compressive strength. RESULTS Compared with untouched controls (L1), both CPC+fibers (L4) and CPC+fibers+GDF5 (L5) numerically or significantly improved all parameters of bone formation, bone resorption, and bone structure. These significant effects were observed both at 3 and 9 months, but for some parameters they were less pronounced at 9 months. Compared with CPC without GDF5, additional significant effects of CPC with GDF5 were demonstrated for BMD and parameters of bone formation and structure (bone volume/total volume, trabecular thickness, and trabecular number, as well as mineralized surface/bone surface). The GDF5 effects were dose-dependent (predominantly in the 5-100 µg range) at 3 and 9 months. CONCLUSIONS GDF5 significantly enhanced the bone formation induced by a PLGA fiber-reinforced CPC in sheep lumbar osteopenia. The results indicated that a local dose as low as ≤100 µg GDF5 may be sufficient to augment middle to long-term bone formation. The novel CPC+GDF5 combination may thus qualify as an alternative to the bioinert, supraphysiologically stiff poly(methyl methacrylate) cement currently applied for vertebroplasty/kyphoplasty of osteoporotic vertebral fractures.
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11
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Gunnella F, Kunisch E, Bungartz M, Maenz S, Horbert V, Xin L, Mika J, Borowski J, Bischoff S, Schubert H, Hortschansky P, Sachse A, Illerhaus B, Günster J, Bossert J, Jandt KD, Plöger F, Kinne RW, Brinkmann O. Low-dose BMP-2 is sufficient to enhance the bone formation induced by an injectable, PLGA fiber-reinforced, brushite-forming cement in a sheep defect model of lumbar osteopenia. Spine J 2017; 17:1699-1711. [PMID: 28619686 DOI: 10.1016/j.spinee.2017.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/23/2017] [Accepted: 06/08/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Bioresorbable calcium phosphate cement (CPC) may be suitable for vertebroplasty/kyphoplasty of osteoporotic vertebral fractures. However, additional targeted delivery of osteoinductive bone morphogenetic proteins (BMPs) in the CPC may be required to counteract the augmented local bone catabolism and support complete bone regeneration. PURPOSE This study aimed at testing an injectable, poly (l-lactide-co-glycolide) acid (PLGA) fiber-reinforced, brushite-forming cement (CPC) containing low-dose bone morphogenetic protein BMP-2 in a sheep lumbar osteopenia model. STUDY DESIGN/ SETTING This is a prospective experimental animal study. METHODS Bone defects (diameter 5 mm) were generated in aged, osteopenic female sheep and filled with fiber-reinforced CPC alone (L4; CPC+fibers) or with CPC containing different dosages of BMP-2 (L5; CPC+fibers+BMP-2; 1, 5, 100, and 500 µg BMP-2; n=5 or 6 each). The results were compared with those of untouched controls (L1). Three and 9 months after the operation, structural and functional effects of the CPC (±BMP-2) were analyzed ex vivo by measuring (1) bone mineral density (BMD); (2) bone structure, that is, bone volume/total volume (assessed by micro-computed tomography [micro-CT] and histomorphometry), trabecular thickness, and trabecular number; (3) bone formation, that is, osteoid volume/bone volume, osteoid surface/bone surface, osteoid thickness, mineralizing surface/bone surface, mineral apposition rate, and bone formation rate/bone surface; (4) bone resorption, that is, eroded surface/bone surface; and (5) compressive strength. RESULTS Compared with untouched controls (L1), CPC+fibers (L4) and/or CPC+fibers+BMP-2 (L5) significantly improved all parameters of bone formation, bone resorption, and bone structure. These effects were observed at 3 and 9 months, but were less pronounced for some parameters at 9 months. Compared with CPC without BMP-2, additional significant effects of BMP-2 were demonstrated for bone structure (bone volume/total volume, trabecular thickness, trabecular number) and formation (osteoid surface/bone surface and mineralizing surface/bone surface), as well as for the compressive strength. The BMP-2 effects on bone formation at 3 and 9 months were dose-dependent, with 5-100 µg as the optimal dosage. CONCLUSIONS BMP-2 significantly enhanced the bone formation induced by a PLGA fiber-reinforced CPC in sheep lumbar osteopenia. A single local dose as low as ≤100 µg BMP-2 was sufficient to augment middle to long-term bone formation. The novel CPC+BMP-2 may thus represent an alternative to the bioinert, supraphysiologically stiff polymethylmethacrylate cement presently used to treat osteoporotic vertebral fractures by vertebroplasty/kyphoplasty.
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Affiliation(s)
- Francesca Gunnella
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Elke Kunisch
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Matthias Bungartz
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany; Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Stefan Maenz
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany; Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, Humboldtstr. 10, 07743 Jena, Germany
| | - Victoria Horbert
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Long Xin
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Joerg Mika
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Juliane Borowski
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Sabine Bischoff
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Dornburger Straße 23, 07743 Jena, Germany
| | - Harald Schubert
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Dornburger Straße 23, 07743 Jena, Germany
| | - Peter Hortschansky
- Leibniz-Institute for Natural Products Research and Infection Biology - Hans-Knoell-Institute, Beutenbergstr. 11a, 07745 Jena, Germany
| | - Andre Sachse
- Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Bernhard Illerhaus
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Dornburger Straße 23, 07743 Jena, Germany
| | - Jens Günster
- BAM Bundesanstalt für Materialforschung und -prüfung (BAM), Unter den Eichen 44-46, 12203 Berlin; Germany
| | - Jörg Bossert
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany
| | - Klaus D Jandt
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany; Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, Humboldtstr. 10, 07743 Jena, Germany; Jena School for Microbial Communication (JSMC), Friedrich Schiller University Jena, Neugasse 23, 07743 Jena, Germany
| | - Frank Plöger
- BIOPHARM GmbH, Handelsstrasse 15, 69214 Eppelheim, Germany
| | - Raimund W Kinne
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany.
| | - Olaf Brinkmann
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany; Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
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Andreasen CM, Ding M, Andersen TL, Overgaard S. Effects of substitute coated with hyaluronic acid or poly‐lactic acid on implant fixation: Experimental study in ovariectomized and glucocorticoid‐treated sheep. J Tissue Eng Regen Med 2017; 12:e1122-e1130. [DOI: 10.1002/term.2447] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/16/2017] [Accepted: 05/04/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Christina M. Andreasen
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology O, Odense University Hospital, Department of Clinical ResearchUniversity of Southern Denmark Odense Denmark
| | - Ming Ding
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology O, Odense University Hospital, Department of Clinical ResearchUniversity of Southern Denmark Odense Denmark
| | - Thomas L. Andersen
- Department of Clinical Cell Biology (KCB), Vejle Hospital – Lillebaelt Hospital, Department of Regional Health ResearchUniversity of Southern Denmark Vejle Denmark
| | - Søren Overgaard
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology O, Odense University Hospital, Department of Clinical ResearchUniversity of Southern Denmark Odense Denmark
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Enhanced bone formation in sheep vertebral bodies after minimally invasive treatment with a novel, PLGA fiber-reinforced brushite cement. Spine J 2017; 17:709-719. [PMID: 27871820 DOI: 10.1016/j.spinee.2016.11.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 09/21/2016] [Accepted: 11/09/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Injectable, brushite-forming calcium phosphate cements (CPC) show potential for bone replacement, but they exhibit low mechanical strength. This study tested a CPC reinforced with poly(l-lactide-co-glycolide) acid (PLGA) fibers in a minimally invasive, sheep lumbar vertebroplasty model. PURPOSE The study aimed to test the in vivo biocompatibility and osteogenic potential of a PLGA fiber-reinforced, brushite-forming CPC in a sheep large animal model. STUDY DESIGN/SETTING This is a prospective experimental animal study. METHODS Bone defects (diameter: 5 mm) were placed in aged, osteopenic female sheep, and left empty (L2) or injected with pure CPC (L3) or PLGA fiber-reinforced CPC (L4; fiber diameter: 25 µm; length: 1 mm; 10% [wt/wt]). Three and 9 months postoperation (n=20 each), the structural and functional CPC effects on bone regeneration were documented ex vivo by osteodensitometry, histomorphometry, micro-computed tomography (micro-CT), and biomechanical testing. RESULTS Addition of PLGA fibers enhanced CPC osteoconductivity and augmented bone formation. This was demonstrated by (1) significantly enhanced structural (bone volume/total volume, shown by micro-CT and histomorphometry; 3 or 9 months) and bone formation parameters (osteoid volume and osteoid surface; 9 months); (2) numerically enhanced bone mineral density (3 and 9 months) and biomechanical compression strength (9 months); and (3) numerically decreased bone erosion (eroded surface; 3 and 9 months). CONCLUSIONS The PLGA fiber-reinforced CPC is highly biocompatible and its PLGA fiber component enhanced bone formation. Also, PLGA fibers improve the mechanical properties of brittle CPC, with potential applicability in load-bearing areas.
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Liu Y, Hu J, Liu B, Jiang X, Li Y. The effect of osteoprotegerin on implant osseointegration in ovariectomized rats. Arch Med Sci 2017; 13:489-495. [PMID: 28261305 PMCID: PMC5332467 DOI: 10.5114/aoms.2017.65468] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 03/12/2015] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Osteoprotegerin (OPG), the endogenous inhibitor of RANKL, prevents or reverses bone loss in a variety of preclinical models of bone disease. Preclinical studies indicate that osteoporosis significantly impairs implant fixation. This study aims to investigate the role of OPG in implant osseointegration in ovariectomized rats. MATERIAL AND METHODS Twelve weeks after bilateral ovariectomy, each rat accepted two titanium screws in the proximal tibiae. All animals were then randomly divided into two groups: the control (10 rats) and OPG group (10 rats). Subcutaneous injection of OPG (10 mg/kg) or vehicle was performed three times a week. Eight weeks later, tibiae with screws were harvested for micro-computed tomography (μCT), histological and biomechanical analysis. RESULTS Compared to control, OPG increased the percent bone volume by 124%, the percent osseointegration by 167%, the mean trabecular number by 111%, the mean trabecular thickness by 92% (p < 0.01), the mean connective density by 95% (p < 0.05); and decreased the mean trabecular separation by 64% in μCT analysis (p < 0.05). Osteoprotegerin also increased bone area density by 160% and bone-to-implant contact by 234% in histomorphometric evaluation (p < 0.01), and increased the maximal push-out force by 228% in biomechanical test (p < 0.01). CONCLUSIONS Systemic administration of OPG improved implant osseointegration and fixation in ovariectomized rats, resulting from the increased peri-implant bone mass and improved trabecular microarchitecture.
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Affiliation(s)
- Yiming Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing Hu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Biao Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiliang Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yunfeng Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Shu R, Ai D, Bai D, Song J, Zhao M, Han X. The effects of SOST on implant osseointegration in ovariectomy osteoporotic mice. Arch Oral Biol 2016; 74:82-91. [PMID: 27918899 DOI: 10.1016/j.archoralbio.2016.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 11/15/2016] [Accepted: 11/20/2016] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Osteoporosis is a risk factor for implant fixation failure. The inhibition of sclerostin effectively improves bone formation and bone remodeling. Therefore, this study investigated whether SOST deficiency enhances the osseointegration of implants in a mouse model of osteoporosis induced by ovariectomy (OVX). DESIGN Osteoporosis was induced in female C57BL/6 and SOST deficient mice by OVX. Titanium implants were placed in the bilateral distal aspects of the femurs. Implants underwent sandblasting and acid-etching after which the structure, surface roughness and chemical components were investigated using scanning electron microscopy (SEM) and energy spectrum analyses. Undecalcified slices, μ-CT, histology analyses and mechanical tests were used to evaluate the osseointegration of implants. The results were compared using one-way ANOVA between four groups. RESULTS Sandblasting and acid-etching increased the roughness of the implants. OVX surgery reduced bone formation around the implants in both WT and SOST-/- mice. However, implant osseointegration was significantly improved in the SOST-/- OVX mice compared to the WT OVX mice. CONCLUSIONS Inhibition of the SOST gene improved implant fixation in the OVX osteoporotic mice, which suggests a strategy for enhancing implant osseointegration in clinical patients with osteoporosis.
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Affiliation(s)
- Rui Shu
- Department of Orthodontics and Pediatric Dentistry, State Key Laboratory of Oral Disease, West China School of Stomatology, Sichuan University, 14, 3rd Sec, Renminnan Rd, Chengdu, Sichuan 610041, China.
| | - Dongqing Ai
- Department of Orthodontics, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China.
| | - Ding Bai
- Department of Orthodontics and Pediatric Dentistry, State Key Laboratory of Oral Disease, West China School of Stomatology, Sichuan University, 14, 3rd Sec, Renminnan Rd, Chengdu, Sichuan 610041, China.
| | - Jinlin Song
- Department of Orthodontics, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China.
| | - Mengyuan Zhao
- Department of Orthodontics and Pediatric Dentistry, State Key Laboratory of Oral Disease, West China School of Stomatology, Sichuan University, 14, 3rd Sec, Renminnan Rd, Chengdu, Sichuan 610041, China.
| | - Xianglong Han
- Department of Orthodontics and Pediatric Dentistry, State Key Laboratory of Oral Disease, West China School of Stomatology, Sichuan University, 14, 3rd Sec, Renminnan Rd, Chengdu, Sichuan 610041, China.
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Significance of osteogenic surface coatings on implants to enhance osseointegration under osteoporotic-like conditions. IMPLANT DENT 2016; 23:679-86. [PMID: 25290281 DOI: 10.1097/id.0000000000000161] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim was to assess the significance of osteogenic surface coatings on implants to enhance osseointegration under osteoporotic-like (OP-like) conditions. METHODS To address the focused question "Do osteogenic surface coatings on implants enhance osseointegration under OP-like conditions?" PubMed/MEDLINE and Google-Scholar databases were searched from 1995 up to and including February 2014 using various keywords. Unpublished data, letters to the editor, review articles, and articles published in languages other than English were excluded. RESULTS Of the 28 studies identified, 11 experimental studies were included. These studies were performed on bilaterally ovariectomized animals. In all studies, implant surface roughness was increased by various osteogenetic surface coatings including alumina, hydroxyapatite, calcium phosphate, and zoledronic acid. Nine studies reported that compared with non-coated surfaces, osteogenic coatings on implant surfaces increases bone volume and bone-to-implant contact (BIC) under OP-like conditions. In 2 studies, there was no difference in BIC around hydroxyapatite-coated implants placed in animals with and without OP-like conditions. CONCLUSION Osteogenic coatings on implant surfaces enhanced osseointegration in animals with OP-like conditions. However, additional clinical studies are warranted to assess the role of osteogenic coatings in increasing osseointegration in patients with osteoporosis.
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Li Y, He S, Hua Y, Hu J. Effect of osteoporosis on fixation of osseointegrated implants in rats. J Biomed Mater Res B Appl Biomater 2016; 105:2426-2432. [PMID: 27618689 DOI: 10.1002/jbm.b.33787] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/29/2016] [Accepted: 08/28/2016] [Indexed: 02/05/2023]
Abstract
The effect of osteoporosis on implant osseointegration has been widely investigated, whereas osteoporosis may also newly occur in patient with previously osseointegrated implant. This study was designed to investigate the effect of osteoporosis on implant fixation in rats after successful osseointegration had been obtained. Seventy female Sprague-Dawley rats were included, and each animal received two titanium implants in the distal metaphysis of femur bilaterally. Eight weeks later, ten rats were sacrificed to confirm the establishment of implant osseointegration. All left rats were randomly subjected to bilateral ovariectomy (OVX) or sham operation. Three, six, and twelve weeks later, implant osseointegration, peri-implant bone tissue, and biomechanical properties of implant were analyzed. Right femurs with implants were used for micro-CT and histological analysis, and left femurs with implants were used for biomechanical test. Micro-CT, histology, and biomechanical test confirmed the destructive effect of OVX on previously osseointegrated implant in rats; when compared to sham-operated rats, peri-implant bone volume, trabecular architecture, bone-to-implant contact ratio, as well as biomechanical parameters decreased progressively within 12 weeks. Results also indicated that the effect of OVX on undisturbed bone (proximal tibiae) was much stronger than that on peri-implant bone. Osteoporosis produced a progressive negative effect on previously osseointegrated implant in distal femora of rats during 12 weeks. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2426-2432, 2017.
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Affiliation(s)
- Yunfeng Li
- Department of Oral & Maxillofacial surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Sheng He
- Department of Oral & Maxillofacial surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Yunwei Hua
- Department of Oral & Maxillofacial surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Jing Hu
- Department of Oral & Maxillofacial surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
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Andreasen CM, Henriksen SS, Ding M, Theilgaard N, Andersen TL, Overgaard S. The efficacy of poly-d,l-lactic acid- and hyaluronic acid-coated bone substitutes on implant fixation in sheep. J Orthop Translat 2016; 8:12-19. [PMID: 30035089 PMCID: PMC5987050 DOI: 10.1016/j.jot.2016.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 07/15/2016] [Accepted: 07/25/2016] [Indexed: 11/18/2022] Open
Abstract
Background/Objective The present study investigated the efficacy of poly-d,l-lactic acid (PDLLA) and hyaluronic acid (HyA) on implant fixation when coated onto hydroxyapatite/beta-tri-calcium phosphate (HA/βTCP) granules. Methods The effect was assessed in a clinically relevant in vivo gap model in sheep. Thus, four titanium implants combined with either allograft (control), pure HA/βTCP, HyA infiltrated HA/βTCP, or PDLLA reinforced HA/βTCP granules were bilaterally inserted into the trabecular bone of the distal femurs in eight sheep. The insertion created a 2-mm peri-implant gap. After 12 weeks, histomorphometry and push-out test was used for quantification of newly formed bone in the gap, bone-implant contact, and implant fixation. Results The histomorphometric analysis revealed the presence of newly formed bone in all groups, though substitute groups showed fragments of nonabsorbed substitute material. A significant larger bone volume was found in the allograft group versus the HA/βTCP-PDLLA group (Zone 1), and in Zone 2 a statistically significantly larger bone volume was found in the allograft compared with the HA/βTCP group. The mechanical properties and the bone-implant contact revealed no statistically significant differences between the groups. Conclusion This study demonstrates that HA/βTCP granules coated with PDLLA and HyA have similar bone ingrowth and implant fixation as those with allograft, and with mechanical properties resembling those of allograft in advance, they may be considered as alternative substitute materials for bone formation in sheep.
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Affiliation(s)
- Christina M. Andreasen
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J. B. Winsloewsvej 15 Ground floor, DK-5000 Odense C, Denmark
- Corresponding author. Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J. B. Winsloewsvej 15 Ground floor, DK-5000 Odense C, Denmark.
| | - Susan S. Henriksen
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J. B. Winsloewsvej 15 Ground floor, DK-5000 Odense C, Denmark
| | - Ming Ding
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J. B. Winsloewsvej 15 Ground floor, DK-5000 Odense C, Denmark
| | - Naseem Theilgaard
- Danish Technological Institute, Gregersensvej 1, 2630 Taastrup, Denmark
| | - Thomas L. Andersen
- Department of Clinical Cell Biology (KCB), Vejle Hospital—Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Vejle, Kabbeltoft 25, DK-7100 Vejle, Denmark
| | - Søren Overgaard
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J. B. Winsloewsvej 15 Ground floor, DK-5000 Odense C, Denmark
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Li Y, He D, Liu B, Hu J. SEMA3A suspended in matrigel improves titanium implant fixation in ovariectomized rats. J Biomed Mater Res B Appl Biomater 2016; 105:2060-2065. [PMID: 27403923 DOI: 10.1002/jbm.b.33730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 05/16/2016] [Accepted: 05/24/2016] [Indexed: 02/05/2023]
Affiliation(s)
- Yunfeng Li
- Department of Oral and Maxillofacial surgery; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University; Chengdu 610041 China
| | - Dongming He
- Department of Oral and Maxillofacial surgery; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University; Chengdu 610041 China
| | - Biao Liu
- Department of Oral and Maxillofacial surgery; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University; Chengdu 610041 China
| | - Jing Hu
- Department of Oral and Maxillofacial surgery; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University; Chengdu 610041 China
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Feng W, Geng Z, Li Z, Cui Z, Zhu S, Liang Y, Liu Y, Wang R, Yang X. Controlled release behaviour and antibacterial effects of antibiotic-loaded titania nanotubes. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 62:105-12. [DOI: 10.1016/j.msec.2016.01.046] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 01/09/2016] [Accepted: 01/19/2016] [Indexed: 11/27/2022]
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Abstract
Osteoporosis is a chronic systemic bone disease of growing relevance due to the on-going demographic change. Since the underlying regulatory mechanisms of this critical illness are still not fully understood and treatment options are not satisfactorily resolved, there is still a great need for osteoporosis research in general and animal models in particular. Ovariectomized rodents are standard animal models for postmenopausal osteoporosis and highly attractive due to the possibility to specifically modify their genetic background. However, some aspects can only be addressed in large animal models; such as metaphyseal fracture healing and advancement of orthopedic implants. Among other large animal models sheep in particular have been proven invaluable for osteoporosis research in this context. In conclusion, today we are able to influence the bone metabolism in animals causing a more or less pronounced systemic bone loss and structural deterioration comparable to the situation found in patients suffering from osteoporosis. However, there is no perfect model for osteoporosis, but a variety of models appropriate for answering specific questions. Though, the appropriateness of an animal model is not only defined in regard to the similarity to human physiology and the disease itself, but also in regard to acquisition, housing requirements, handling, costs, and particularly ethical concerns and animal welfare.
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Affiliation(s)
- Ralf Oheim
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
| | - Thorsten Schinke
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Pia Pogoda
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
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Harboe K, Ellingsen CL, Sudmann E, Gjerdet NR, Søreide K, Indrekvam K. Can bone apposition predict the retention force of a femoral stem? An experimental weight-bearing hip-implant model in goats. BMC Musculoskelet Disord 2015; 16:102. [PMID: 25927813 PMCID: PMC4423176 DOI: 10.1186/s12891-015-0560-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 04/21/2015] [Indexed: 11/24/2022] Open
Abstract
Background The increasing incidence of prosthesis revision surgery in the Western world has led to an increased focus on the capacity for stem removal. We previously reported on a femoral stem implanted in goats with an approximate 15% reduction in retention force by drilling longitudinally orientated grooves on the side of the stem. In this current study, we aimed to histologically evaluate the bony apposition towards this stem and correlate this apposition with the pullout force. Methods We analyzed the femora of 22 goats after stem removal. All stems remained in place for 6 months, and the goats were allowed regular loading of the hip during this time. For histological evaluation, all femora were immersed in EDTA and decalcified until sufficiently soft for standard technique preparation. We evaluated bone apposition, the presence of foreign particle debris and other factors. The apposition was evaluated with a scoring system based on semi-quantitative bone apposition in four quadrants. Kappa statistics were calculated for the score. We correlated the retention force with the amount of bone apposition. Results The stem drilling was the only significant factor influencing the retention force (p = 0.020). The bone apposition Kappa score comparing poor and good apposition scores was fair (κ = 0.4, 95% CI 0.00–0.88). Signs of foreign body reaction were noted in 5 of 22 goats. Conclusions Based on the current findings in an experimental goat model, it appears that the effect of drilling tissue/bone out of the longitudinal grooves has a more significant impact on the retention force required to remove the stem than the amount of bone apposition outside the stem grooves. This observation may be further explored in the research of stem designs that are potentially easier to remove.
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Affiliation(s)
- Knut Harboe
- Department of Orthopedic Surgery, Stavanger University Hospital, P.O. Box 8100, Stavanger, 4068, Norway. .,Department of Clinical Medicine, University of Bergen, Bergen, Norway.
| | | | - Einar Sudmann
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.
| | - Nils Roar Gjerdet
- Department of Clinical Dentistry, Biomaterials, University of Bergen, Bergen, Norway.
| | - Kjetil Søreide
- Department of Clinical Medicine, University of Bergen, Bergen, Norway. .,Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.
| | - Kari Indrekvam
- Department of Clinical Medicine, University of Bergen, Bergen, Norway. .,Kysthospitalet in Hagevik, Clinic of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway.
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Li Y, Shui X, Zhang L, Hu J. Cancellous bone healing around strontium-doped hydroxyapatite in osteoporotic rats previously treated with zoledronic acid. J Biomed Mater Res B Appl Biomater 2015; 104:476-81. [PMID: 25891947 DOI: 10.1002/jbm.b.33417] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 02/16/2015] [Accepted: 03/04/2015] [Indexed: 02/05/2023]
Affiliation(s)
- Yunfeng Li
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University; Chengdu 610041 China
| | - Xueping Shui
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University; Chengdu 610041 China
| | - Li Zhang
- Research Center for Nano-Biomaterials, Analytical and Testing Center, Sichuan University; Chengdu 610064 China
| | - Jing Hu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University; Chengdu 610041 China
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Characterization of the aspects of osteoprogenitor cell interactions with physical tetracalcium phosphate anchorage on titanium implant surfaces. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 49:7-13. [DOI: 10.1016/j.msec.2014.12.063] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 08/29/2014] [Accepted: 12/17/2014] [Indexed: 12/27/2022]
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Cancellous bone response to strontium-doped hydroxyapatite in osteoporotic rats. J Appl Biomater Funct Mater 2015; 13:28-34. [PMID: 24744229 DOI: 10.5301/jabfm.5000168] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2013] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The objective of this study was to investigate cancellous bone response to strontium-doped hydroxyapatite (SrHA) in ovariectomized (OVX) rats. METHODS Hydroxyapatite (HA) and 10%SrHA (HA with 10 mol% calcium substituted by strontium) implants were prepared and characterized by scanning electronic microscopy (SEM), energy dispersive microanalysis (EDX) and X-ray diffraction (XRD). Twelve weeks after bilateral ovariectomy, 20 rats randomly received HA or 10%SrHA implants in the right distal femur, with 10 animals in each group. Eight weeks after implantation, specimens were harvested and analyzed by micro-computed tomography (micro-CT) and histology. RESULTS Compared with HA, 10%SrHA raised the percentage bone volume by 42.6%, bone-to-implant contact by 47.1%, mean trabecular number by 27.3%, mean trabecular thickness by 31.5% and mean connectivity density by 37.4%, while it decreased mean trabecular separation by 20.1% in micro-CT evaluation. 10%SrHA also increased the bone area density by 47.6% in histological analysis. CONCLUSIONS With the HA implants as controls, the 10%SrHA implants were shown to increase bone density and bone-to-implant contact, and improve trabecular architecture in the vicinity of implant surfaces.
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Bertollo N, Sandrini E, Dalla Pria P, Walsh WR. Osseointegration of multiphase anodic spark deposition treated porous titanium implants in an ovine model. J Arthroplasty 2015; 30:484-8. [PMID: 25540993 DOI: 10.1016/j.arth.2013.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 09/11/2013] [Accepted: 10/03/2013] [Indexed: 02/01/2023] Open
Abstract
Modification of titanium oxide by multiphase anodic spark deposition (ASD) has the potential to increase bioactivity and hasten osseointegration and biological fixation in uncemented arthroplasty. This study assessed the in vivo performance of control (Ti), plasma-sprayed HA-coated (TiHA) and ASD (Biospark) treated (TiAn) porous titanium implants with a solid core using a standard uncemented implant fixation sheep model. Cortical interfacial shear-strength and bone ingrowth in cortical and cancellous sites were quantified following 12 weeks in situ. Ultimate shear-strength for the Ti, TiHA and TiAn coatings was 33±9.5, 35.4±8.4 and 33.8±7.8 MPa, respectively, which was limited by coating delamination. ASD treatment was associated with significantly higher mean bone ingrowth at both sites. These results support the osteoconductive potential of the BioSpark treatment of porous titanium.
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Affiliation(s)
- Nicky Bertollo
- Surgical & Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital Clinical School, Sydney, Australia
| | | | | | - William R Walsh
- Surgical & Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital Clinical School, Sydney, Australia
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Calderoni DR, Gilioli R, Munhoz ALJ, Maciel Filho R, Zavaglia CADC, Lambert CS, Lopes ÉSN, Toro IFC, Kharmandayan P. Paired evaluation of calvarial reconstruction with prototyped titanium implants with and without ceramic coating. Acta Cir Bras 2014; 29:579-87. [DOI: 10.1590/s0102-8650201400150005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 07/23/2014] [Indexed: 11/21/2022] Open
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Ross RD, Hamilton JL, Wilson BM, Sumner DR, Virdi AS. Pharmacologic augmentation of implant fixation in osteopenic bone. Curr Osteoporos Rep 2014; 12:55-64. [PMID: 24293098 DOI: 10.1007/s11914-013-0182-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Osteoporosis presents a challenge for successful implant fixation due to an impaired healing response. Preclinical studies have consistently reported reduced osseointegration capability in trabecular bone. Although clinical studies of implant success in dentistry have not found a negative effect due to osteoporosis, low bone mass is a significant risk factor for implant migration in orthopedics. Pharmacologic treatment options that limit bone resorption or upregulate formation have been studied preclinically. While, both treatment options improve implant fixation, direct comparisons to-date have found anti-catabolic more effective than anabolic treatments for establishing implant fixation, but combination approaches are better than either treatment alone. Clinically, anti-catabolic treatments, particularly bisphosphonates have been shown to increase the longevity of implants, while limited clinical evidence on the effects of anabolic treatment exists. Preclinical experiments are needed to determine the effects of osteoporosis and subsequent treatment on the long-term maintenance of fixation and recovery after bone loss.
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Affiliation(s)
- R D Ross
- Anatomy and Cell Biology, Rush University Medical Center, 600 S. Paulina Street, Suite # AcFc 507, Chicago, IL, 60612, USA
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Çalışkan N, Bayram C, Erdal E, Karahaliloğlu Z, Denkbaş EB. Titania nanotubes with adjustable dimensions for drug reservoir sites and enhanced cell adhesion. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2013; 35:100-5. [PMID: 24411357 DOI: 10.1016/j.msec.2013.10.033] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 10/04/2013] [Accepted: 10/29/2013] [Indexed: 10/26/2022]
Abstract
This study aims to generate a bactericidal agent releasing surface via nanotube layer on titanium metal and to investigate how aspect ratio of nanotubes affects drug elution time and cell proliferation. Titania nanotube layers were generated on metal surfaces by anodic oxidation at various voltage and time parameters. Gentamicin loading was carried out via simple pipetting and the samples were tested against S. aureus for the efficacy of the applied modification. Drug releasing time and cell proliferation were also tested in vitro. Titania nanotube layers with varying diameters and lengths were prepared after anodization and anodizing duration was found as the most effective parameter for amount of loaded drug and drug releasing time. Drug elution lasted up to 4 days after anodizing for 80 min of the samples, whereas release completed in 24 h when the samples were anodized for 20 min. All processed samples had bactericidal properties against S. aureus organism except unmodified titanium, which was also subjected to drug incorporation step. The anodization also enhanced water wettability and cell adhesion results. Anodic oxidation is an effective surface modification to enhance tissue-implant interactions and also resultant titania layer can act as a drug reservoir for the release of bactericidal agents. The use of implants as local drug eluting devices is promising but further in vivo testing is required.
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Affiliation(s)
- Nazlı Çalışkan
- Hacettepe University, Institute of Science and Technology, Nanotechnology and Nanomedicine Division, Beytepe, 06800, Ankara, Turkey
| | - Cem Bayram
- Hacettepe University, Institute of Science and Technology, Nanotechnology and Nanomedicine Division, Beytepe, 06800, Ankara, Turkey
| | - Ebru Erdal
- Hacettepe University, Institute of Science and Technology, Nanotechnology and Nanomedicine Division, Beytepe, 06800, Ankara, Turkey
| | - Zeynep Karahaliloğlu
- Hacettepe University, Institute of Science and Technology, Nanotechnology and Nanomedicine Division, Beytepe, 06800, Ankara, Turkey
| | - Emir Baki Denkbaş
- Hacettepe University, Institute of Science and Technology, Nanotechnology and Nanomedicine Division, Beytepe, 06800, Ankara, Turkey.
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Mantripragada VP, Lecka-Czernik B, Ebraheim NA, Jayasuriya AC. An overview of recent advances in designing orthopedic and craniofacial implants. J Biomed Mater Res A 2013; 101:3349-64. [PMID: 23766134 PMCID: PMC4854641 DOI: 10.1002/jbm.a.34605] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 01/11/2013] [Accepted: 01/11/2013] [Indexed: 01/22/2023]
Abstract
Great deal of research is still going on in the field of orthopedic and craniofacial implant development to resolve various issues being faced by the industry today. Despite several disadvantages of the metallic implants, they continue to be used, primarily because of their superior mechanical properties. In order to minimize the harmful effects of the metallic implants and its by-products, several modifications are being made to these materials, for instance nickel-free stainless steel, cobalt-chromium and titanium alloys are being introduced to eliminate the toxic effects of nickel being released from the alloys, introduce metallic implants with lower modulus, reduce the cost of these alloys by replacing rare elements with less expensive elements etc. New alloys like tantalum, niobium, zirconium, and magnesium are receiving attention given their satisfying mechanical and biological properties. Non-oxide ceramics like silicon nitride and silicon carbide are being currently developed as a promising implant material possessing a combination of properties such as good wear and corrosion resistance, increased ductility, good fracture and creep resistance, and relatively high hardness in comparison to alumina. Polymer/magnesium composites are being developed to improve mechanical properties as well as retain polymer's property of degradation. Recent advances in orthobiologics are proving interesting as well. This paper thus deals with the latest improvements being made to the existing implant materials and includes new materials being introduced in the field of biomaterials.
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Bolelli G, Bellucci D, Cannillo V, Lusvarghi L, Sola A, Stiegler N, Müller P, Killinger A, Gadow R, Altomare L, De Nardo L. Suspension thermal spraying of hydroxyapatite: microstructure and in vitro behaviour. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2013; 34:287-303. [PMID: 24268261 DOI: 10.1016/j.msec.2013.09.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 08/02/2013] [Accepted: 09/18/2013] [Indexed: 12/27/2022]
Abstract
In cementless fixation of metallic prostheses, bony ingrowth onto the implant surface is often promoted by osteoconductive plasma-sprayed hydroxyapatite coatings. The present work explores the use of the innovative High Velocity Suspension Flame Spraying (HVSFS) process to coat Ti substrates with thin homogeneous hydroxyapatite coatings. The HVSFS hydroxyapatite coatings studied were dense, 27-37μm thick, with some transverse microcracks. Lamellae were sintered together and nearly unidentifiable, unlike conventional plasma-sprayed hydroxyapatite. Crystallinities of 10%-70% were obtained, depending on the deposition parameters and the use of a TiO2 bond coat. The average hardness of layers with low (<24%) and high (70%) crystallinity was ≈3.5GPa and ≈4.5GPa respectively. The distributions of hardness values, all characterised by Weibull modulus in the 5-7 range, were narrower than that of conventional plasma-sprayed hydroxyapatite, with a Weibull modulus of ≈3.3. During soaking in simulated body fluid, glassy coatings were progressively resorbed and replaced by a new, precipitated hydroxyapatite layer, whereas coatings with 70% crystallinity were stable up to 14days of immersion. The interpretation of the precipitation behaviour was also assisted by surface charge assessments, performed through Z-potential measurements. During in vitro tests, HA coatings showed no cytotoxicity towards the SAOS-2 osteoblast cell line, and surface cell proliferation was comparable with proliferation on reference polystyrene culture plates.
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Affiliation(s)
- Giovanni Bolelli
- Department of Engineering "Enzo Ferrari", Università di Modena e Reggio Emilia, Via Vignolese 905, 41125 Modena, MO, Italy.
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Alghamdi HS, Jansen JA. Bone Regeneration Associated with Nontherapeutic and Therapeutic Surface Coatings for Dental Implants in Osteoporosis. TISSUE ENGINEERING PART B-REVIEWS 2013; 19:233-53. [DOI: 10.1089/ten.teb.2012.0400] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Hamdan S. Alghamdi
- Department of Biomaterials, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - John A. Jansen
- Department of Biomaterials, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Alghamdi HS, Bosco R, van den Beucken JJ, Walboomers XF, Jansen JA. Osteogenicity of titanium implants coated with calcium phosphate or collagen type-I in osteoporotic rats. Biomaterials 2013; 34:3747-57. [DOI: 10.1016/j.biomaterials.2013.02.033] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 02/12/2013] [Indexed: 02/07/2023]
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Cheng Z, Guo C, Dong W, He FM, Zhao SF, Yang GL. Effect of thin nano-hydroxyapatite coating on implant osseointegration in ovariectomized rats. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 113:e48-53. [PMID: 22669157 DOI: 10.1016/j.tripleo.2011.07.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2010] [Revised: 06/30/2011] [Accepted: 07/04/2011] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to investigate the effect of the thin nano-hydroxyapatite (nano-HA) coating on implant osseointegration in an ovariectomized rat model. MATERIALS AND METHODS Implants were divided into a control group and a test group (nano-HA-coated group). Surface morphology was examined using field-emission scanning electron microscopy (FSEM). Surface roughness of both groups was performed. Sixteen ovariectomized rats randomly received 2 implants in both tibiae. After 12 weeks of implantation, tibias were retrieved and prepared for histomorphometric evaluation and removal torque tests (RTQ). RESULTS Rodlike crystals uniformly covered the porous surfaces and the surface morphology of the implant was still clear. No significant differences were found in surface roughness between the 2 groups (P > .05). More bone tissue was formed around test implants compared with control implants. Test implants showed a significantly greater BIC, bone area within all threads, and RTQ values compared with control implants (P < .05). CONCLUSIONS These results indicate the thin nano-HA coating by an electrochemical process has potential benefits to enhance implant osseointegration in ovariectomized rats.
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Affiliation(s)
- Zhipeng Cheng
- Department of Implantology, Stomatology Hospital, School of Medical, Zhejiang University, Yan'an Road, Hangzhou, China
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35
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Chen X, Li Y, Aparicio C. Biofunctional Coatings for Dental Implants. THIN FILMS AND COATINGS IN BIOLOGY 2013. [DOI: 10.1007/978-94-007-2592-8_4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Thoma DS, Martin IS, Mühlemann S, Jung RE. Systematic review of pre-clinical models assessing implant integration in locally compromised sites and/or systemically compromised animals. J Clin Periodontol 2012; 39 Suppl 12:37-62. [PMID: 22533946 DOI: 10.1111/j.1600-051x.2011.01833.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim was to systematically search the dental literature for pre-clinical models assessing implant integration in locally compromised sites (part 1) and systemically compromised animals (part 2), and to evaluate the quality of reporting of included publications. METHODS A Medline search (1966-2011) was performed, complimented by additional hand searching. The quality of reporting of the included publications was evaluated using the 20 items of the ARRIVE (Animals in Research In Vivo Experiments) guidelines. RESULTS One-hundred and seventy-six (part 1; mean ARRIVE score = 15.6 ± 2.4) and 104 (part 2; 16.2 ± 1.9) studies met the inclusion criteria. The overall mean score for all included studies amounted to 15.8 ± 2.2. Housing (38.3%), allocation of animals (37.9%), numbers analysed (50%) and adverse events (51.4%) of the ARRIVE guidelines were the least reported. Statistically significant differences in mean ARRIVE scores were found depending on the publication date (p < 0.05), with the highest score of 16.7 ± 1.6 for studies published within the last 2 years. CONCLUSIONS A large number of studies met the inclusion criteria. The ARRIVE scores revealed heterogeneity and missing information for selected items in more than 50% of the publications. The quality of reporting shifted towards better-reported pre-clinical trials within recent years.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
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37
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Wennerberg A, Albrektsson T. Structural influence from calcium phosphate coatings and its possible effect on enhanced bone integration. Acta Odontol Scand 2012; 67:333-40. [PMID: 19722110 DOI: 10.1080/00016350903188325] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of this review was to summarize our present knowledge about calcium phosphate (CaP) coatings on implants with respect to their topographical appearance at micrometer as well as nanometer level and also the reported influence on bone healing. MATERIAL AND METHODS The PubMed database was used with the key words - surface roughness, CaP coating, implant, bone integration, clinical studies, experimental studies - used in different combinations. Only in vivo studies were taken into consideration. CONCLUSIONS A significantly improved healing capacity associated with CaP-coated implants is often reported, but individual importance of the several modes of surface changes introduced, deliberately or not, is usually very difficult to interpret. Several studies claim this difference to be due to altered chemistry, but in many the result may equally well be dependent on the surface topography. The few studies that have been published indicate that nanometer structures have an impact on early bone healing. However, the optimal size and distribution of nanometer-sized particles or pores applied on implant surfaces is still unknown, as are the evaluation effects of micrometer roughness. Improved surface characterization is needed if we are to reveal effects dependent on isolated nanometer alterations.
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Shi L, Wang L, Zhang Y, Guo Z, Wu ZX, Liu D, Gao MX, Chen H, Fu SC, Lei W. Improving fixation strength of pedicle screw by microarc oxidation treatment: an experimental study of osteoporotic spine in sheep. J Orthop Res 2012; 30:1296-303. [PMID: 22234960 DOI: 10.1002/jor.22072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Accepted: 12/23/2011] [Indexed: 02/04/2023]
Abstract
Failure of fixation caused by loosening of pedicle screws in osteoporosis is a problem in spinal surgery. We compared the in vivo fixation strength between pedicle screws treated with microarc oxidation (MAO) and untreated screws in an osteoporotic model of ovariectomized sheep. The MAO treated and untreated screws were placed in lumbar vertebral bodies. After 3 months of implantation, biomechanical tests, micro-CT analysis, and histological observations were conducted to examine the performance of the two groups. At time 0, no significant difference was found between the two groups in biomechanical tests (p > 0.05); 3 months later, higher pull-out strength and load with less displacement were detected in the MAO-treated group (p < 0.05). Micro-CT analysis showed that the tissue mineral density, bone volume fraction, trabecular thickness, and trabecular number in the MAO-treated group were all higher than those in untreated group (p < 0.05), and trabecular spacing was smaller (p < 0.05). Histologically, the bone-implant interface in the MAO-treated group was better than that in untreated group (p < 0.05). In conclusion, pedicle screws with a bioactive surface treated by MAO can improve screw fixation strength in osteoporotic spines in sheep.
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Affiliation(s)
- Lei Shi
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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39
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Alghamdi HS, Junker R, Bronkhorst EM, Jansen JA. Bone regeneration related to calcium phosphate-coated implants in osteoporotic animal models: a meta-analysis. TISSUE ENGINEERING PART B-REVIEWS 2012; 18:383-95. [PMID: 22519708 DOI: 10.1089/ten.teb.2012.0130] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Osteoporosis is a frequent human metabolic bone disorder. Prospectively, global ageing of populations will lead to a major increase of subjects being diagnosed with osteoporosis and in need for dental rehabilitation. However, as local osteoporosis of the jaws affects bone quantity and quality of edentulous regions, osseointegration of dental implants might be hampered. Consequently, calcium phosphate ceramic-coated implants have been suggested to compensate for low bone quantity/density and for impaired bone healing in osteoporosis. Nonetheless, up to now no meta-analytical assessment of the relevant preclinical literature to quantify such a possible positive effect has been undertaken. MATERIALS AND METHODS PubMed search, limited to animal models, to identify a possible positive effect of calcium phosphate-coated implants on bone regeneration, was carried out. Further, the reference lists of related review articles and publications selected for inclusion in this review were systematically screened. The primary outcome variables were bone-to-implant contact percentage as assessed histomorphometrically and mechanical stability testing. RESULTS The electronic search in the database of the National Library of Medicine resulted in the identification of 2704 titles. These titles were initially screened by the two independent reviewers for possible inclusion, resulting in further consideration of 51 publications. Screening the abstracts led to 22 full-text articles. From these articles, 16 reports were excluded. Finally, six of these original research reports could be selected for evaluation. Additionally, eight publications were identified by manual search. Thus, a total of 14 articles were included for analysis. CONCLUSIONS It was concluded that (1) in osteoporotic animal models calcium phosphate ceramic-coated implants are associated with improved bone-to-implant healing as compared to noncoated implants. Moreover, (2) essentially due to quality characteristics of the analyzed original research articles a negative impact of osteoporosis on bone-to-implant healing could not be confirmed. Besides, (3) the established positive bone-to-implant healing effect of calcium phosphate ceramic coatings does not differ between osteoporotic and nonosteoporotic, healthy animal models.
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Affiliation(s)
- Hamdan S Alghamdi
- Department of Biomaterials, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Song W, Markel DC, Wang S, Shi T, Mao G, Ren W. Electrospun polyvinyl alcohol-collagen-hydroxyapatite nanofibers: a biomimetic extracellular matrix for osteoblastic cells. NANOTECHNOLOGY 2012; 23:115101. [PMID: 22370251 DOI: 10.1088/0957-4484/23/11/115101] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The failure of prosthesis after total joint replacement is due to the lack of early implant osseointegration. In this study polyvinyl alcohol-collagen-hydroxyapatite (PVA-Col-HA) electrospun nanofibrous meshes were fabricated as a biomimetic bone-like extracellular matrix for the modification of orthopedic prosthetic surfaces. In order to reinforce the PVA nanofibers, HA nanorods and Type I collagen were incorporated into the nanofibers. We investigated the morphology, biodegradability, mechanical properties and biocompatibility of the prepared nanofibers. Our results showed these inorganic-organic blended nanofibers to be degradable in vitro. The encapsulated nano-HA and collagen interacted with the PVA content, reinforcing the hydrolytic resistance and mechanical properties of nanofibers that provided longer lasting stability. The encapsulated nano-HA and collagen also enhanced the adhesion and proliferation of murine bone cells (MC3T3) in vitro. We propose the PVA-Col-HA nanofibers might be promising modifying materials on implant surfaces for orthopedic applications.
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Affiliation(s)
- Wei Song
- Department of Biomedical Engineering, Wayne State University, Detroit, MI, USA.
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Fini M, Giavaresi G, Salamanna F, Veronesi F, Martini L, De Mattei M, Tschon M. Harmful lifestyles on orthopedic implantation surgery: a descriptive review on alcohol and tobacco use. J Bone Miner Metab 2011; 29:633-44. [PMID: 21898177 DOI: 10.1007/s00774-011-0309-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 08/11/2011] [Indexed: 11/26/2022]
Abstract
Alcohol abuse and smoking habits have adverse effects on bone health and are a risk factor for osteoporosis, fractures and impaired fracture repair. Osteointegration processes around implanted biomaterials involve a coordinated cascade of complex events that are very similar to those occurring during fracture repair and require a suitable microenvironment and the coordinated action of cells and signal molecules. Therefore, diseases and harmful lifestyles that impair the normal bone healing process can reduce the success of implant surgery and may negatively influence the osteointegration of prostheses and implant devices for fracture fixation such as screws, nails and plates. Understanding the effects of harmful lifestyles on bone implant osteointegration is important for successful implant therapy, orthopedic reconstructive surgery and tissue-engineered-based therapies. However, the mechanisms by which smoking and alcoholism affect bone metabolism, bone mass and the balance of bone resorption and formation, also in the presence of an orthopedic implant, are not completely understood and remain inadequately elucidated. This review aims to analyze in vitro and in vivo studies regarding orthopedic implant integration in the presence of tobacco smoking and alcohol consumption with a focus on pathophysiology and local or systemic mechanisms of action on bone.
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Affiliation(s)
- Milena Fini
- Laboratory of Preclinical and Surgical Studies, Research Institute Codivilla-Putti, Rizzoli Orthopaedic Institute, via di Barbiano, 1/10, 40136 Bologna, Italy.
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Jensen T, Jakobsen T, Baas J, Nygaard JV, Dolatshahi-Pirouz A, Hovgaard MB, Foss M, Bünger C, Besenbacher F, Søballe K. Hydroxyapatite nanoparticles in poly-D,L-lactic acid coatings on porous titanium implants conducts bone formation. J Biomed Mater Res A 2011; 95:665-72. [PMID: 20725972 DOI: 10.1002/jbm.a.32863] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
It is well established in the field of biomaterials that hydroxyapatite (HA) may provide interesting osteoconductive properties. In this study, we investigated the osseointegrational effect of a 50/50 vol % composite of HA nanoparticles and poly-D,L-lactic acid (PDLLA) coated on model titanium bone implants in an in vivo animal model. The aim is to evaluate how the addition of HA to PDLLA may improve the bone formation and initial fixation of the implant. Two titanium implants coated with the PDLLA/HA composite and pure PDLLA, respectively, were implanted bilaterally in proximal part of humeri with a 2-mm peri-implant gap in 10 sheep. After 12 weeks, the remains of the coatings were present on 20.3 and 19.8% of PDLLA/HA composite- and PDLLA-coated implants, respectively. It was observed that newly formed bone (39.3%) and fibrous tissue (58.3%) had replaced the PDLLA/HA composite, whereas pure PDLLA was replaced almost completely by fibrous tissue (96.2%). Consequently, the PDLLA/HA composite-coated implants were better fixated as confirmed by push-out tests. Using quantification of peri-implant tissue and implant fixation as parameters, the present findings, therefore, clearly reveal that the addition of nanoparticulate HA to a PDLLA coating on titanium implants increases osseointegration.
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Affiliation(s)
- Thomas Jensen
- Orthopaedic Research Lab, Department of Orthopaedics, University Hospital of Aarhus, Aarhus C, Denmark
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Keränen P, Koort J, Itälä A, Ylänen H, Dalstra M, Hupa M, Kommonen B, Aro HT. Bioceramic inlays do not improve mechanical incorporation of grit-blasted titanium stems in the proximal sheep femur. J Biomed Mater Res A 2010; 92:1578-86. [PMID: 19437438 DOI: 10.1002/jbm.a.32494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of the present study was to determine, if bioactive glass (BG) surface inlays improve osseointegration of titanium implants in the proximal femur of adult sheep. In simulation of uncemented primary stems (nine animals), only the proximal part of the implants was grit-blasted and three surface slots of the grit-blasted region were filled with sintered BG microspheres. Primary stems were implanted using press-fit technique. In revision stem simulation (eight animals), grit-blasting was extended over the whole implant and seven perforating holes of the stem were filled by sintered BG granules. Revision stems were implanted with a mixture of autogenous bone graft and BG granules. Comparison with solid partially or fully grit-blasted control stems implanted in the contralateral femurs was performed in the primary and revision stem experiments at 12 and 25 weeks, respectively. Implant incorporation was evaluated by torsional failure testing and histomorphometry. Only one-third of the primary stems anchored mechanically to bone. The revision stems incorporated better and the BG inlays of the revision stems showed ingrowth of new bone. However, there were no significant differences in the torsional failure loads between the stems with BG inlays and the control stems. In conclusion, surface BG inlays gave no measurable advantage in mechanical incorporation of grit-blasted titanium implants. Overall, the proximal sheep femur, characterized by minimal amount of cancellous bone and the presence of adipocytic bone marrow, seemed to present compromised bone healing conditions.
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Affiliation(s)
- Pauli Keränen
- Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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Jung JY, Hong YJ, Choi YS, Jeong S, Lee WK. A new method for the preparation of bioactive calcium phosphate films hybridized with 1alpha,25-dihydroxyvitamin D3. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2009; 20:2441-2453. [PMID: 19593649 DOI: 10.1007/s10856-009-3817-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Accepted: 07/01/2009] [Indexed: 05/28/2023]
Abstract
The primary goal of this investigation was to develop a calcium phosphate film hybridized with 1alpha,25-dihydroxyvitamin D(3) for the improvement of osteoconductivity of bone substitutes. The hybrid films (hCaP) were prepared at the different concentrations of 1 x 10(-10), 1 x 10(-8), and 1 x 10(-6) M designated as hCaPL, hCaPM, and hCaPH, respectively. The change of the hormone concentration during the preparation of the hybrid films did not cause significant variations on the physical properties of hCaPs, i.e. surface morphology and roughness. On the other hand, X-ray photon spectroscope (XPS) measurements revealed that the concentration change affected the chemical composition of the hybrid films. Recruitment of osteoblast-like MG-63 cells was considerably improved on hCaPs compared to tissue culture plate (TCP). However, cell proliferation on hCaPs was substantially suppressed and inversely proportional to the hormone concentration used. It was observed that bone-like nodules which consisted of bead-like components and well-developed matrix were rapidly formed on hCaPs. Masson's trichrome and safranin-O stainings elucidated that the bead-like components were MG-63 cells. Safranin-O staining showed that proteoglycan was produced actively. These results indicate that the cells cultured on hCaPs were strongly stimulated by the hormone to produce proteoglycan which can be considered as an induction of premature bone formation. The number of the nodules was increased with hormone concentration and most pronounced at the hCaPH. Gene expression patterns of alkaline phosphatase (ALP), transforming growth factor-beta (TGF-beta), and osteopontin (OPN) were strongly modulated by hybridized the hormone. For ALP and OPN, gene expressions were activated earlier on hCaPs than untreated calcium phosphate (CaP) confirming the effect of the hybridization was substantial. The TGF-beta gene expression was immediately activated after seeding but difference between samples was not significant suggesting that the gene expression was modulated not by the hormone hybridization but by CaP itself. As a result, hybridization of 1,25(OH)(2)D(3) with CaP can be a potentially strong candidate to promote osteoconductivity of implant materials.
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Affiliation(s)
- Jae-Young Jung
- Department of Chemical Engineering, Institute of Tissue Regeneration Engineering, College of Engineering, Dankook University, Yongin-si, Gyeonggi-do, Korea
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Borsari V, Fini M, Giavaresi G, Tschon M, Chiesa R, Chiusoli L, Salito A, Rimondini L, Giardino R. Comparativein vivoevaluation of porous and dense duplex titanium and hydroxyapatite coating with high roughnesses in different implantation environments. J Biomed Mater Res A 2009; 89:550-60. [DOI: 10.1002/jbm.a.31995] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Schlegel P, Hayes JS, Frauchiger VM, Gasser B, Wieling R, Textor M, Richards RG. An in vivo evaluation of the biocompatibility of anodic plasma chemical (APC) treatment of titanium with calcium phosphate. J Biomed Mater Res B Appl Biomater 2008; 90:26-34. [PMID: 18985774 DOI: 10.1002/jbm.b.31249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- P Schlegel
- AO Research Institute, AO Foundation, Davos, Switzerland
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Reinwald S, Burr D. Review of nonprimate, large animal models for osteoporosis research. J Bone Miner Res 2008; 23:1353-68. [PMID: 18505374 PMCID: PMC2683153 DOI: 10.1359/jbmr.080516] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Revised: 05/07/2008] [Accepted: 05/23/2008] [Indexed: 11/18/2022]
Abstract
Large animal models are required for preclinical prevention and intervention studies related to osteoporosis research. The challenging aspect of this requirement is that no single animal model exactly mimics the progression of this human-specific chronic condition. There are pros and cons associated with the skeletal, hormonal, and metabolic conditions of each species that influence their relevance and applicability to human physiology. Of all larger mammalian species, nonhuman primates (NHPs) are preeminent in terms of replicating important aspects of human physiology. However, NHPs are very expensive, putting them out of reach of the vast majority of researchers. Practical, cost-effective alternatives to NHPs are sought after among ungulate (porcine, caprine, and ovine) and canine species that are the focus of this review. The overriding caveat to using large lower-order species is to take the time in advance to understand and appreciate the limitations and strengths of each animal model. Under these circumstances, experiments can be strategically designed to optimize the potential of an animal to develop the cardinal features of postmenopausal bone loss and/or yield information of relevance to treatment.
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Affiliation(s)
- Susan Reinwald
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
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