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Anderson KD, Ko FC, Fullam S, Virdi AS, Wimmer MA, Sumner D, Ross RD. The relative contribution of bone microarchitecture and matrix composition to implant fixation strength in rats. J Orthop Res 2022; 40:862-870. [PMID: 34061392 PMCID: PMC8633073 DOI: 10.1002/jor.25107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/21/2021] [Accepted: 05/25/2021] [Indexed: 02/04/2023]
Abstract
Bone microarchitectural parameters significantly contribute to implant fixation strength but the role of bone matrix composition is not well understood. To determine the relative contribution of microarchitecture and bone matrix composition to implant fixation strength, we placed titanium implants in 12-week-old intact Sprague-Dawley rats, ovariectomized-Sprague-Dawley rats, and Zucker diabetic fatty rats. We assessed bone microarchitecture by microcomputed tomography, bone matrix composition by Raman spectroscopy, and implant fixation strength at 2, 6, and 10 weeks postimplantation. A stepwise linear regression model accounted for 83.3% of the variance in implant fixation strength with osteointegration volume/total volume (50.4%), peri-implant trabecular bone volume fraction (14.2%), cortical thickness (9.3%), peri-implant trabecular crystallinity (6.7%), and cortical area (2.8%) as the independent variables. Group comparisons indicated that osseointegration volume/total volume was significantly reduced in the ovariectomy group at Week 2 (~28%) and Week 10 (~21%) as well as in the diabetic group at Week 10 (~34%) as compared with the age matched Sprague-Dawley group. The crystallinity of the trabecular bone was significantly elevated in the ovariectomy group at Week 2 (~4%) but decreased in the diabetic group at Week 10 (~3%) with respect to the Sprague-Dawley group. Our study is the first to show that bone microarchitecture explains most of the variance in implant fixation strength, but that matrix composition is also a contributing factor. Therefore, treatment strategies aimed at improving bone-implant contact and peri-implant bone volume without compromising matrix quality should be prioritized.
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Affiliation(s)
- Kyle D. Anderson
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL
| | - Frank C. Ko
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL,Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Spencer Fullam
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Amarjit S. Virdi
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL,Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Markus A. Wimmer
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL,Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - D.R. Sumner
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL,Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Ryan D. Ross
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL,Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
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Grossi JRA, Deliberador TM, Giovanini AF, Zielak JC, Sebstiani AM, Gonzaga CC, Coelho PG, Zétola AL, Weiss FP, Benalcázar Jalkh EB, Storrer CLM, Witek L. Effects of local single dose administration of parathormone on the early stages of osseointegration: A pre-clinical study. J Biomed Mater Res B Appl Biomater 2022; 110:1806-1813. [PMID: 35218605 DOI: 10.1002/jbm.b.35038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/27/2021] [Accepted: 02/09/2022] [Indexed: 11/06/2022]
Abstract
The present study aimed to evaluate the effect of parathormone (PTH) administered directly to the implant's surface prior to insertion, using a large translational animal model. Sixty titanium implants were divided into four groups: (i) Collagen, control group, where implants were coated with Type-I Bovine-collagen, and three experimental groups, where implants received varying doses of PTH: (ii) 12.5, (iii) 25, and (iv) 50 μg, prior to placement. Fifteen female sheep (~2 years old, weighing ~65 kg) received four implants in an interpolated fashion in C3, C4 or C5 vertebral bodies. After 3-, 6- and 12-weeks, samples were harvested, histologically processed, qualitatively and quantitatively assessed for bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). BIC yielded lower values at 6-weeks for 50 μg relative to the control group, with no significant differences, when compared to the 12.5- and 25-μg. No significant differences were detected at 6-weeks between collagen, 12.5- and 25-μg groups. At 3- and 12-weeks, no differences were detected for BIC among PTH groups. With respect to BAFO, no significant differences were observed between the control and experimental groups independent of PTH concentration and time in vivo. Qualitative observations at 3-weeks indicated the presence of a more mature bone near the implant's surface with the application of PTH, however, no significant differences in new bone formation or healing patterns were observed at 6- and 12-weeks. Single local application of different concentrations of PTH on titanium implant's surface did not influence the osseointegration at any time-point evaluation in low-density bone.
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Affiliation(s)
| | | | | | - João César Zielak
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, Paraná, Brazil
| | | | - Carla Castiglia Gonzaga
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, Paraná, Brazil
| | - Paulo G Coelho
- Department of Biomaterials, New York University College of Dentistry, New York, New York, USA.,Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, New York, USA.,Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, New York, USA
| | - André Luis Zétola
- Department of Oral and Maxillofacial Surgery, Universidade Positivo, Curitiba, Paraná, Brazil
| | - Fernando P Weiss
- Department of Biomaterials, New York University College of Dentistry, New York, New York, USA
| | - Ernesto B Benalcázar Jalkh
- Department of Biomaterials, New York University College of Dentistry, New York, New York, USA.,Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, São Paulo, Brazil
| | | | - Lukasz Witek
- Department of Biomaterials, New York University College of Dentistry, New York, New York, USA.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, USA
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Zhou Y, Hu Z, Ge M, Jin W, Tang R, Li Q, Xu W, Shi J, Xie Z. Intraosseous Injection of Calcium Phosphate Polymer-Induced Liquid Precursor Increases Bone Density and Improves Early Implant Osseointegration in Ovariectomized Rats. Int J Nanomedicine 2021; 16:6217-6229. [PMID: 34531654 PMCID: PMC8439716 DOI: 10.2147/ijn.s321882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/09/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Osteoporosis, due to bone loss and structural deterioration, is a risk factor for dental implant failure, as it impedes initial stability and osseointegration. We aim to assess the effects of calcium phosphate polymer-induced liquid precursor (CaP-PILP) treatment, which significantly increases bone density and improves early implant osseointegration in ovariectomized rats. METHODS In this study, CaP-PILP was synthesized and characterized through TEM, FTIR and XRD. A rat model of osteoporosis was generated by ovariectomy. CaP-PILP or hydroxyapatite (HAP, negative control) was injected into the tibia, and the resulting changes in bone quality were determined. Further, implants were installed in the treated tibias, and implantation characteristics were assessed after 4 weeks. RESULTS The CaP-PILP group had superior bone repair. Importantly, CaP-PILP had excellent properties, similar to those of normal bone, in terms of implant osseointegration. In vivo experiment displayed that CaP-PILP group had better bone contact rate (65.97±3.176) than HAP and OVX groups. Meanwhile, a mound of mature and continuous new bone formed. Moreover, the values of BIC and BA showed no significant difference between the CaP-PILP group and the sham group. CONCLUSION In summary, CaP-PILP is a promising material for application in poor-quality bones to improve implant success rates in patients with osteoporosis. This research provides new perspectives on the application of nano-apatite materials in bone repair.
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Affiliation(s)
- Yanyan Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
| | - Zihe Hu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
| | - Mingjie Ge
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
| | - Wenjing Jin
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
| | - Ruikang Tang
- Center for Biomaterials and Biopathways, Department of Chemistry, Zhejiang University, Hangzhou, 310027, People’s Republic of China
| | - Qi Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
| | - Weijian Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
| | - Jue Shi
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
| | - Zhijian Xie
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
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Abstract
PURPOSE OF REVIEW The purpose of this review is to critically evaluate the current literature regarding implant fixation in osteoporotic bone. RECENT FINDINGS Clinical studies have not only demonstrated the growing prevalence of osteoporosis in patients undergoing total joint replacement (TJR) but may also indicate a significant gap in screening and treatment of this comorbidity. Osteoporosis negatively impacts bone in multiple ways beyond the mere loss of bone mass, including compromising skeletal regenerative capacity, architectural deterioration, and bone matrix quality, all of which could diminish implant fixation. Recent findings both in preclinical animal models and in clinical studies indicate encouraging results for the use of osteoporosis drugs to promote implant fixation. Implant fixation in osteoporotic bone presents an increasing clinical challenge that may be benefitted by increased screening and usage of osteoporosis drugs.
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Affiliation(s)
- Kyle D Anderson
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Frank C Ko
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Amarjit S Virdi
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - D Rick Sumner
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Ryan D Ross
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL, 60612, USA.
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA.
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Tao Z, Zhou W, Wu X, Lu H, Ma N, Li Y, Zhang R, Yang M, Xu HG. Local administration of aspirin improves osseointegration of hydroxyapatite-coated titanium implants in ovariectomized rats through activation of the Notch signaling pathway. J Biomater Appl 2019; 34:1009-1018. [PMID: 31757183 DOI: 10.1177/0885328219889630] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Zhoushan Tao
- Department of Trauma orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Anhui, People's Republic of China
| | - Wanshu Zhou
- Department of Geriatrics, The Second Affiliated Hospital of Wannan Medical College, Anhui, People's Republic of China
| | - Xingjing Wu
- Department of Trauma orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Anhui, People's Republic of China
| | - Hanli Lu
- Department of Trauma orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Anhui, People's Republic of China
| | - Nengfeng Ma
- Department of Trauma orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Anhui, People's Republic of China
| | - Yang Li
- Department of Trauma orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Anhui, People's Republic of China
| | - Ruotian Zhang
- Department of Trauma orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Anhui, People's Republic of China
| | - Min Yang
- Department of Trauma orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Anhui, People's Republic of China
| | - Hong-Guang Xu
- Department of Spine Surgery, Spine Research Center of Wannan Medical College, Key Laboratory of Non-coding RNA Transformation Research of Anhui Higher Education Institution, Yijishan hospital of Wannan Medical College, Anhui, People's Republic of China
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Yamashita J, McCauley LK. Effects of Intermittent Administration of Parathyroid Hormone and Parathyroid Hormone-Related Protein on Fracture Healing: A Narrative Review of Animal and Human Studies. JBMR Plus 2019; 3:e10250. [PMID: 31844831 PMCID: PMC6894727 DOI: 10.1002/jbm4.10250] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 10/08/2019] [Accepted: 10/30/2019] [Indexed: 12/17/2022] Open
Abstract
Intermittent administration of parathyroid hormone (PTH) stimulates skeletal remodeling and is a potent anabolic agent in bone. PTH‐related protein (PTHrP) is anabolic acting on the same PTH1 receptor and is in therapeutic use for osteoporosis. The body of literature for PTH actions in fracture healing is emerging with promising yet not entirely consistent results. The objective of this review was to perform a literature analysis to extract up‐to‐date knowledge on the effects of intermittent PTH and PTHrP therapy in bone fracture healing. A literature search of the PubMed database was performed. Clinical case studies and articles related to “regeneration,” “implant,” and “distraction osteogenesis” were excluded. A narrative review was performed to deliberate the therapeutic potential of intermittent PTH administration on fracture healing. A smaller number of studies centered on the use of PTHrP or a PTHrP analog were also reviewed. Animal studies clearly show that intermittent PTH therapy promotes fracture healing and revealed the strong therapeutic potential of PTH. Human subject studies were fewer and not as consistent as the animal studies yet provide insight into the potential of intermittent PTH administration on fracture healing. Differences in outcomes for animal and human studies appear to be attributed partly to variable doses, fracture sites, age, remodeling patterns, and bone architectures, although other factors are involved. Future studies to examine the dose, timing, and duration of PTH administration will be necessary to further delineate the therapeutic potential of PTH for fracture healing in humans. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Junro Yamashita
- Center for Regenerative Medicine, Fukuoka Dental College Fukuoka Japan
| | - Laurie K McCauley
- Department of Periodontics and Oral Medicine, School of Dentistry University of Michigan Ann Arbor MI USA.,Department of Pathology, Medical School University of Michigan Ann Arbor MI USA
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7
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Tao ZS, Wu XJ, Yang M, Xu HG. Local administration with silymarin could increase osseointegration of hydroxyapatite-coated titanium implants in ovariectomized rats. J Biomater Appl 2019; 34:664-672. [PMID: 31342833 DOI: 10.1177/0885328219863290] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Zhou-Shan Tao
- 1 Department of Trauma orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Anhui, People's Republic of China
| | - Xing-Jing Wu
- 1 Department of Trauma orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Anhui, People's Republic of China
| | - Min Yang
- 1 Department of Trauma orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Anhui, People's Republic of China
| | - Hong-Guang Xu
- 2 Department of Spine Surgery, Spine Research Center of Wannan Medical College, Key Laboratory of Non-coding RNA Transformation Research of Anhui Higher Education Institution, Yijishan hospital of Wannan Medical College. Anhui, People's Republic of China
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Ross RD, Deng Y, Fang R, Frisch NB, Jacobs JJ, Sumner DR. Discovery of biomarkers to identify peri-implant osteolysis before radiographic diagnosis. J Orthop Res 2018; 36:2754-2761. [PMID: 29873110 PMCID: PMC6482967 DOI: 10.1002/jor.24044] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 05/07/2018] [Indexed: 02/04/2023]
Abstract
Peri-implant osteolysis is commonly diagnosed after substantial bone loss has occurred, making revision surgery more challenging. The goal of the current study was to identify urinary biomarkers that differentiate total hip replacement patients who eventually develop osteolysis from patients who do not. We used a repository of 24-h urine samples collected prior to surgery and annually thereafter in 26 patients, 16 who developed osteolysis, and 10 who did not. We examined the markers at radiographic diagnosis, annually for 6 years preceding diagnosis, at the first post-operative sampling point, and pre-operatively. Patients in the osteolysis and non-osteolysis groups were matched according to time post-surgery and did not differ in the male:female ratio or age at surgery. Seven candidate biomarkers were measured, including free deoxypyridinoline (DPD), cross-linked N-telopeptides (NTX), interleukin-6 (IL-6), interleukin-8 (IL-8), osteoprotegerin (OPG), α-crosslaps (α-CTX), and β-crosslaps (β-CTX). As an individual biomarker, DPD demonstrated the highest ability to predict osteolysis, with an area under the curve (AUC) in Receiver Operating Characteristic (ROC) analyses of 0.844 at 6 years prior to diagnosis. A panel of α-CTX and IL-6 was able to identify at-risk patients with an AUC of 0.941 or greater at all post-operative time points and an AUC of 1.000 pre-operatively. The results demonstrate the potential of using non-invasive biomarkers to identify patients at risk for peri-implant osteolysis long before the emergence of radiographic signs. Further, the high accuracy of the pre-operative biomarker levels demonstrates the potential importance of pre-existing, patient-specific factors driving subsequent osteolysis. Study Design © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2754-2761, 2018.
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Affiliation(s)
- Ryan D. Ross
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL 60612,Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612
| | - Youping Deng
- Department of Complementary & Integrative Medicine, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii 96813, USA
| | - Rui Fang
- Department of Complementary & Integrative Medicine, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii 96813, USA
| | - Nicholas B. Frisch
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612
| | - Joshua J. Jacobs
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612
| | - D. Rick Sumner
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL 60612,Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612
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Li X, Xue W, Cao Y, Long Y, Xie M. Effect of lycopene on titanium implant osseointegration in ovariectomized rats. J Orthop Surg Res 2018; 13:237. [PMID: 30223885 PMCID: PMC6142359 DOI: 10.1186/s13018-018-0944-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 09/05/2018] [Indexed: 02/07/2023] Open
Abstract
Background Lycopene prevents bone loss in osteopenic models. However, the role of lycopene in the success rate of dental implants under osteopenic conditions remains unknown. The aim of this study was to evaluate whether lycopene prevents delayed implant osseointegration in an ovariectomized (OVX) rat model. Methods Thirty female Sprague-Dawley rats were randomly divided into the following groups: OVX with vehicle (OVX group), OVX with lycopene (OVX + lycopene group) and sham-operated with vehicle (sham group). Twelve weeks after ovariectomy or sham operation, titanium implants were placed into the distal metaphysis of the bilateral femurs of each rat. These rats were subsequently gavaged with lycopene (50 mg/kg/day) or vehicle. After 12 weeks of gavage, all rats were sacrificed, and specimens were harvested. Sample osseointegration was evaluated by biomechanical testing, 3D micro-computed tomography (micro-CT) analysis and histomorphometric analysis. Results Compared with the OVX group, the OVX + lycopene group showed a 69.3% increase in the maximum push-out force (p < 0.01). Micro-CT data for the femurs in the OVX + lycopene group showed significantly higher bone volume, trabecular thickness and less trabecular space than did those in the OVX group. The bone area (BA) around the implant and bone contact (BC) with the implant were increased by 72.3% (p < 0.01) and 51.4% (p < 0.01) in the OVX + lycopene group, respectively, compared with those in the OVX group. There was no significant difference in the mechanical test, micro-CT scanning and histomorphometric data between the OVX + lycopene and sham groups (p > 0.05). Conclusions Lycopene improved implant osseointegration, fixation and bone formation under osteopenic conditions, suggesting that lycopene is a promising therapeutic agent to prevent delayed implant osseointegration and bone loss under osteopenic conditions.
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Affiliation(s)
- Xiaojie Li
- Department of Prosthodontics, College and Hospital of Stomatology, Guangxi Medical University, 10th Shuangyong Road, Nanning, 530021, China.
| | - Wenli Xue
- Department of Prosthodontics, College and Hospital of Stomatology, Guangxi Medical University, 10th Shuangyong Road, Nanning, 530021, China
| | - Yong Cao
- Department of Prosthodontics, College and Hospital of Stomatology, Guangxi Medical University, 10th Shuangyong Road, Nanning, 530021, China
| | - Yanming Long
- Department of Prosthodontics, College and Hospital of Stomatology, Guangxi Medical University, 10th Shuangyong Road, Nanning, 530021, China
| | - Mengsheng Xie
- Department of Prosthodontics, College and Hospital of Stomatology, Guangxi Medical University, 10th Shuangyong Road, Nanning, 530021, China
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10
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Li Z, Müller R, Ruffoni D. Bone remodeling and mechanobiology around implants: Insights from small animal imaging. J Orthop Res 2018; 36:584-593. [PMID: 28975660 DOI: 10.1002/jor.23758] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 09/27/2017] [Indexed: 02/04/2023]
Abstract
Anchorage of orthopedic implants depends on the interfacial bonding between the implant and the host bone as well as on the mass and microstructure of peri-implant bone, with all these factors being continuously regulated by the biological process of bone (re)modeling. In osteoporotic bone, implant integration may be jeopardized not only by lower peri-implant bone quality but also by reduced intrinsic regeneration ability. The first aim of this review is to provide a critical overview of the influence of osteoporosis on bone regeneration post-implantation. Mechanical stimulation can trigger bone formation and inhibit bone resorption; thus, judicious administration of mechanical loading can be used as an effective non-pharmacological treatment to enhance implant anchorage. Our second aim is to report recent achievements on the application of external mechanical stimulation to improve the quantity of peri-implant bone. The review focuses on peri-implant bone changes in osteoporotic conditions and following mechanical loading, prevalently using small animals and in vivo monitoring approaches. We intend to demonstrate the necessity to reveal new biological information on peri-implant bone mechanobiology to better target implant anchorage and fracture fixation in osteoporotic conditions. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:584-593, 2018.
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Affiliation(s)
- Zihui Li
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Ralph Müller
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Davide Ruffoni
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland.,Mechanics of Biological and Bioinspired Materials Laboratory, Department of Aerospaceand Mechanical Engineering, University of Liège, Liège, Belgium
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11
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Moran MM, Wilson BM, Ross RD, Virdi AS, Sumner DR. Arthrotomy-based preclinical models of particle-induced osteolysis: A systematic review. J Orthop Res 2017; 35:2595-2605. [PMID: 28548682 PMCID: PMC5702596 DOI: 10.1002/jor.23619] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 05/24/2017] [Indexed: 02/04/2023]
Abstract
We completed a systematic literature review of in vivo animal models that use arthrotomy-based methods to study particle-induced peri-implant osteolysis. The purpose of the review was to characterize the models developed to date, to determine the questions addressed, to assess scientific rigor and transparency, and to identify gaps in knowledge. We probed three literature databases (Medline, Embase, and Scopus) and found 77 manuscripts that fit the search parameters. In the most recent 10 years, researchers mainly used rat and mouse models, whereas in the previous 20 years, large animal, canine, and rabbit models were more common. The studies have demonstrated several pathophysiology pathways, including macrophage migration, particle phagocytosis, increased local production of cytokines and lysosomal enzymes, elevated bone resorption, and suppressed bone formation. The effect of variation in particle characteristics and concentration received limited attention with somewhat mixed findings. Particle contamination by endotoxin was shown to exacerbate peri-implant osteolysis. The possibility of early diagnosis was demonstrated through imaging and biomarker approaches. Several studies showed that both local and systemic delivery of bisphosphonates inhibits the development of particle-induced osteolysis. Other methods of inhibiting osteolysis include the use of anabolic agents and altering the implant design. Few studies examined non-surgical rescue of loosened implants, with conflicting results with alendronate. We found that the manuscripts often lacked the methodological detail now advocated by the ARRIVE guidelines, suggesting that improvement in reporting would be useful to maximize rigor and transparency. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2595-2605, 2017.
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Affiliation(s)
- Meghan M. Moran
- Department of Anatomy and Cell Biology, Rush University Medical Center
| | | | - Ryan D. Ross
- Department of Anatomy and Cell Biology, Rush University Medical Center
| | - Amarjit S. Virdi
- Department of Anatomy and Cell Biology, Rush University Medical Center
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Virdi AS, Irish J, Sena K, Liu M, Ke HZ, McNulty MA, Sumner DR. Sclerostin antibody treatment improves implant fixation in a model of severe osteoporosis. J Bone Joint Surg Am 2015; 97:133-40. [PMID: 25609440 DOI: 10.2106/jbjs.n.00654] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The mechanical fixation of orthopaedic and dental implants is compromised by diminished bone volume, such as with osteoporosis. Systemic administration of sclerostin antibody (Scl-Ab) has been shown to enhance implant fixation in normal animals. In the present study, we tested whether Scl-Ab can improve implant fixation in established osteoporosis in a rat model. METHODS We used an ovariectomized (ovx) rat model, in which we found a 78% decrease in trabecular bone volume at the time of implant surgery; sham-ovx, age-matched rats were used as controls. After placement of a titanium implant in the medullary cavity of the distal aspect of the femur, the rats were maintained for four, eight, or twelve weeks and treated biweekly with Scl-Ab or with the delivery vehicle alone. Outcomes were measured with use of microcomputed tomography, mechanical testing, and static and dynamic histomorphometry. RESULTS Scl-Ab treatment doubled implant fixation strength in both the sham-ovx and ovx groups, although the enhancement was delayed in the ovx group. Scl-Ab treatment also enhanced bone-implant contact; increased peri-implant trabecular thickness and volume; and increased cortical thickness. These structural changes were associated with an approximately five to sevenfold increase in the bone-formation rate and a >50% depression in the eroded surface following Scl-Ab treatment. Trabecular bone thickness and bone-implant contact accounted for two-thirds of the variance in fixation strength. CONCLUSIONS In this model of severe osteoporosis, Scl-Ab treatment enhanced implant fixation by stimulating bone formation and suppressing bone resorption, leading to enhanced bone-implant contact and improved trabecular bone volume and architecture. CLINICAL RELEVANCE Systemic administration of anti-sclerostin antibodies might be a useful strategy in total joint replacement when bone mass is deficient.
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Affiliation(s)
- Amarjit S Virdi
- Department of Anatomy and Cell Biology, Rush University Medical Center, 600 South Paulina Street, Suite 507, Chicago, IL 60612. E-mail address for A.S. Virdi:
| | - John Irish
- Department of Anatomy and Cell Biology, Rush University Medical Center, 600 South Paulina Street, Suite 507, Chicago, IL 60612. E-mail address for A.S. Virdi:
| | - Kotaro Sena
- Department of Periodontology, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Min Liu
- Metabolic Disorders, Amgen, Inc., One Amgen Center Drive, 29-1-A, Thousand Oaks, CA 91320
| | - Hua Zhu Ke
- Metabolic Disorders, Amgen, Inc., One Amgen Center Drive, 29-1-A, Thousand Oaks, CA 91320
| | - Margaret A McNulty
- Department of Comparative Biomedical Sciences, Louisiana State University School of Veterinary Medicine, Skip Bertman Drive, Baton Rouge, LA 70803
| | - Dale R Sumner
- Department of Anatomy and Cell Biology, Rush University Medical Center, 600 South Paulina Street, Suite 507, Chicago, IL 60612. E-mail address for A.S. Virdi:
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Sumner DR. Long-term implant fixation and stress-shielding in total hip replacement. J Biomech 2014; 48:797-800. [PMID: 25579990 DOI: 10.1016/j.jbiomech.2014.12.021] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2014] [Indexed: 11/16/2022]
Abstract
Implant fixation implies a strong and durable mechanical bond between the prosthetic component and host skeleton. Assuming the short-term impediments to implant fixation are successfully addressed and that longer-term issues such as late infection and mechanical failure of the components are avoided, the biological response of the host tissue to the presence of the implant is critical to long-term success. In particular, maintenance of adequate peri-prosthetic bone stock is a key factor. Two major causes of bone loss in the supporting bone are adverse bone remodeling in response to debris shed from the implant and stress-shielding. Here, I review some of the major lessons learned from studying stress-shielding-induced bone loss. It is well known that stress-shielding can be manipulated by altering implant design, but less well appreciated that the development of bone anabolic agents may make it possible to reduce the severity of stress-shielding and the associated bone loss by augmenting the host skeleton through the use of locally or systemically delivered agents. In most cases, mechanical, material and biological factors do not act in isolation, emphasizing that it is often not possible to optimize all boundary conditions.
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Affiliation(s)
- D R Sumner
- Departments of Anatomy and Cell Biology and Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, United States.
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Vegt P, Muir JM, Block JE. The Photodynamic Bone Stabilization System: a minimally invasive, percutaneous intramedullary polymeric osteosynthesis for simple and complex long bone fractures. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2014; 7:453-61. [PMID: 25540600 PMCID: PMC4270358 DOI: 10.2147/mder.s71790] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The treatment of osteoporotic long bone fractures is difficult due to diminished bone density and compromised biomechanical integrity. The majority of osteoporotic long bone fractures occur in the metaphyseal region, which poses additional problems for surgical repair due to increased intramedullary volume. Treatment with internal fixation using intramedullary nails or plating is associated with poor clinical outcomes in this patient population. Subsequent fractures and complications such as screw pull-out necessitate additional interventions, prolonging recovery and increasing health care costs. The Photodynamic Bone Stabilization System (PBSS) is a minimally invasive surgical technique that allows clinicians to repair bone fractures using a light-curable polymer contained within an inflatable balloon catheter, offering a new treatment option for osteoporotic long bone fractures. The unique polymer compound and catheter application provides a customizable solution for long bone fractures that produces internal stability while maintaining bone length, rotational alignment, and postsurgical mobility. The PBSS has been utilized in a case series of 41 fractures in 33 patients suffering osteoporotic long bone fractures. The initial results indicate that the use of the light-cured polymeric rod for this patient population provides excellent fixation and stability in compromised bone, with a superior complication profile. This paper describes the clinical uses, procedural details, indications for use, and the initial clinical findings of the PBSS.
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Affiliation(s)
- Paul Vegt
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
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