1
|
Bioactive Glass Applications: A Literature Review of Human Clinical Trials. MATERIALS 2021; 14:ma14185440. [PMID: 34576662 PMCID: PMC8470635 DOI: 10.3390/ma14185440] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 12/11/2022]
Abstract
The use of bioactive glasses in dentistry, reconstructive surgery, and in the treatment of infections can be considered broadly beneficial based on the emerging literature about the potential bioactivity and biocompatibility of these materials, particularly with reference to Bioglass® 45S5, BonAlive® and 19-93B3 bioactive glasses. Several investigations have been performed (i) to obtain bioactive glasses in different forms, such as bulk materials, powders, composites, and porous scaffolds and (ii) to investigate their possible applications in the biomedical field. Although in vivo studies in animals provide us with an initial insight into the biological performance of these systems and represent an unavoidable phase to be performed before clinical trials, only clinical studies can demonstrate the behavior of these materials in the complex physiological human environment. This paper aims to carefully review the main published investigations dealing with clinical trials in order to better understand the performance of bioactive glasses, evaluate challenges, and provide an essential source of information for the tailoring of their design in future applications. Finally, the paper highlights the need for further research and for specific studies intended to assess the effect of some specific dissolution products from bioactive glasses, focusing on their osteogenic and angiogenic potential.
Collapse
|
2
|
Palmroth A, Salpavaara T, Vuoristo P, Karjalainen S, Kääriäinen T, Miettinen S, Massera J, Lekkala J, Kellomäki M. Materials and Orthopedic Applications for Bioresorbable Inductively Coupled Resonance Sensors. ACS APPLIED MATERIALS & INTERFACES 2020; 12:31148-31161. [PMID: 32568505 PMCID: PMC7467565 DOI: 10.1021/acsami.0c07278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/22/2020] [Indexed: 06/11/2023]
Abstract
Bioresorbable passive resonance sensors based on inductor-capacitor (LC) circuits provide an auspicious sensing technology for temporary battery-free implant applications due to their simplicity, wireless readout, and the ability to be eventually metabolized by the body. In this study, the fabrication and performance of various LC circuit-based sensors are investigated to provide a comprehensive view on different material options and fabrication methods. The study is divided into sections that address different sensor constituents, including bioresorbable polymer and bioactive glass substrates, dissolvable metallic conductors, and atomic layer deposited (ALD) water barrier films on polymeric substrates. The manufactured devices included a polymer-based pressure sensor that remained pressure responsive for 10 days in aqueous conditions, the first wirelessly readable bioactive glass-based resonance sensor for monitoring the complex permittivity of its surroundings, and a solenoidal coil-based compression sensor built onto a polymeric bone fixation screw. The findings together with the envisioned orthopedic applications provide a reference point for future studies related to bioresorbable passive resonance sensors.
Collapse
Affiliation(s)
- Aleksi Palmroth
- BioMediTech,
Faculty of Medicine and Health Technology, Tampere University, Korkeakoulunkatu 3, Tampere 33720, Finland
| | - Timo Salpavaara
- BioMediTech,
Faculty of Medicine and Health Technology, Tampere University, Korkeakoulunkatu 3, Tampere 33720, Finland
| | - Petri Vuoristo
- Materials
Science and Environmental Engineering, Faculty of Engineering and
Natural Sciences, Tampere University, Korkeakoulunkatu 6, Tampere 33720, Finland
| | - Sanna Karjalainen
- BioMediTech,
Faculty of Medicine and Health Technology, Tampere University, Korkeakoulunkatu 3, Tampere 33720, Finland
| | - Tommi Kääriäinen
- Department
of Chemistry, University of Colorado Boulder, Boulder, Colorado 80309, United States
| | - Susanna Miettinen
- BioMediTech,
Faculty of Medicine and Health Technology, Tampere University, Korkeakoulunkatu 3, Tampere 33720, Finland
| | - Jonathan Massera
- BioMediTech,
Faculty of Medicine and Health Technology, Tampere University, Korkeakoulunkatu 3, Tampere 33720, Finland
| | - Jukka Lekkala
- BioMediTech,
Faculty of Medicine and Health Technology, Tampere University, Korkeakoulunkatu 3, Tampere 33720, Finland
| | - Minna Kellomäki
- BioMediTech,
Faculty of Medicine and Health Technology, Tampere University, Korkeakoulunkatu 3, Tampere 33720, Finland
| |
Collapse
|
3
|
Reconstruction of Medial Wall Blowout Fracture Defect with a Combination of Resorbable Meshed Plate and Cancellous Bone Allograft. BIOMED RESEARCH INTERNATIONAL 2019; 2019:2656503. [PMID: 31737658 PMCID: PMC6815640 DOI: 10.1155/2019/2656503] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/04/2019] [Accepted: 08/11/2019] [Indexed: 11/21/2022]
Abstract
Background Various materials are available for the reconstruction of bone defects in cases of medial wall blowout fracture. This study was conducted to assess the efficacy of the combination of a resorbable meshed plate and cancellous bone allograft. Methods From March 2014 to March 2017, a total of 111 patients were evaluated. Sixty-three patients received reconstruction surgery with porous polyethylene plates (control group) and the other forty-eight patients underwent operation with a resorbable meshed plate plus allogenic cancellous bone (combined group). The results were assessed by exophthalmometric measurements, width, and volume discrepancies as compared with the unaffected orbit, and operation time. Results The difference in exophthalmometric measurements between the affected and unaffected orbits were 0.94 ± 0.70 mm in the control group and 1.05 ± 0.73 mm in the combined group without statistical significance (p = 0.425). In the analysis of computed tomography images, the width discrepancy was 1.55 ± 0.86 mm and 1.08 ± 0.69 mm, respectively (p = 0.003); however, the volume discrepancy demonstrated no statistically significant difference (2.58 ± 1.40 cm3 versus 2.20 ± 1.80 cm3; p = 0.209). Operation time was significantly shorter in the combined group as compared with the control group (43.0 ± 7.0 versus 38.3 ± 7.0 minutes; p = 0.001). Conclusion The combination material composed of resorbable meshed plate and cancellous bone allograft made reconstruction surgery of medial wall blowout fracture easier and quicker to perform with long-lasting results.
Collapse
|
4
|
Pihlman H, Keränen P, Paakinaho K, Linden J, Hannula M, Manninen IK, Hyttinen J, Manninen M, Laitinen-Vapaavuori O. Novel osteoconductive β-tricalcium phosphate/poly(L-lactide-co-e-caprolactone) scaffold for bone regeneration: a study in a rabbit calvarial defect. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:156. [PMID: 30298429 DOI: 10.1007/s10856-018-6159-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 09/18/2018] [Indexed: 06/08/2023]
Abstract
The advantages of synthetic bone graft substitutes over autogenous bone grafts include abundant graft volume, lack of complications related to the graft harvesting, and shorter operation and recovery times for the patient. We studied a new synthetic supercritical CO2 -processed porous composite scaffold of β-tricalcium phosphate and poly(L-lactide-co-caprolactone) copolymer as a bone graft substitute in a rabbit calvarial defect. Bilateral 12 mm diameter critical size calvarial defects were successfully created in 18 rabbits. The right defect was filled with a scaffold moistened with bone marrow aspirate, and the other was an empty control. The material was assessed for applicability during surgery. The follow-up times were 4, 12, and 24 weeks. Radiographic and micro-CT studies and histopathological analysis were used to evaluate new bone formation, tissue ingrowth, and biocompatibility. The scaffold was easy to shape and handle during the surgery, and the bone-scaffold contact was tight when visually evaluated after the implantation. The material showed good biocompatibility and its porosity enabled rapid invasion of vasculature and full thickness mesenchymal tissue ingrowth already at four weeks. By 24 weeks, full thickness bone ingrowth within the scaffold and along the dura was generally seen. In contrast, the empty defect had only a thin layer of new bone at 24 weeks. The radiodensity of the material was similar to the density of the intact bone. In conclusion, the new porous scaffold material, composed of microgranular β-TCP bound into the polymer matrix, proved to be a promising osteoconductive bone graft substitute with excellent handling properties.
Collapse
Affiliation(s)
- Hanna Pihlman
- Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
| | - Pauli Keränen
- Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Kaarlo Paakinaho
- Faculty of Medicine and Life Sciences, Biomeditech, University of Tampere, Tampere, Finland
- Orton Orthopaedic Hospital, Helsinki, Finland
| | - Jere Linden
- Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Markus Hannula
- Faculty of Biomedical Science and Engineering, Tampere University of Technology, Tampere, Finland
| | | | - Jari Hyttinen
- Faculty of Medicine and Life Sciences, Biomeditech, University of Tampere, Tampere, Finland
| | | | | |
Collapse
|
5
|
Abstract
INTRODUCTION The use of resorbable materials is becoming more popular for pediatric orbital floor reconstruction. The purpose of this systematic review is to evaluate the effectiveness and safety of the various materials used in pediatric orbital floor reconstruction. METHODS A systematic literature search was performed to identify all relevant articles reporting complications following pediatric orbital floor reconstruction. The search included published articles in three electronic databases-Ovid MEDLINE, EMBASE, and PubMed starting from database establishment to July 2017. Primary endpoints were enophthalmos, diplopia, and infection. Resorbable material was compared to autologous grafts and nonresorbable material. RESULTS A total of 14 studies containing 248 patients were included in this review. Fifty-four (21.8%) patients had reconstruction performed with autologous grafts, 72 (29.0%) patients with resorbable material, and 122 (49.2%) patients with nonresorbable material. Resorbable materials had the lowest rate of postoperative enophthalmos (3/52; 5.8%) and the highest rate of postoperative diplopia (19/72; 26.4%). In contrast, nonresorbable materials had the lowest rate of postoperative diplopia (5/122; 4.1%), the highest rate of postoperative enophthalmos (14/102; 13.7%). Autologous reconstruction was associated with an 11.1% (4/36) rate of postoperative enophthalmos and a 22.2% (12/54) rate of postoperative diplopia. Nine cases (8.8%) of postoperative infection were documented with nonresorbable materials. No cases of infection were reported with autologous grafts or resorbable materials. CONCLUSION Newer resorbable implants are safe and have a similar complication profile as traditional autologous grafts in pediatric orbital floor reconstruction.
Collapse
|
6
|
Chen XY, Xu SZ, Wang XW, Yang XY, Ma L, Zhang L, Yang GJ, Yang F, Wang LH, Zhang XL, Ting K, Gao CY, Mou XZ, Gou ZR, Zou H. Systematic comparison of biologically active foreign ions-codoped calcium phosphate microparticles on osteogenic differentiation in rat osteoporotic and normal mesenchymal stem cells. Oncotarget 2017; 8:36578-36590. [PMID: 28402265 PMCID: PMC5482678 DOI: 10.18632/oncotarget.16618] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 03/06/2017] [Indexed: 11/25/2022] Open
Abstract
Osteoporosis is a disease characterized by structural deterioration of bone tissue, leading to skeletal fragility with increased fracture risk. Calcium phosphates (CaPs) are widely used in bone tissue engineering strategies as they have similarities to bone apatite except for the absence of trace elements (TEs) in the CaPs. Bioactive glasses (BGs) have also been used successfully in clinic for craniomaxillofacial and dental applications during the last two decades due to their excellent potential for bonding with bone and inducing osteoblastic differentiation. In this study, we evaluated the osteogenic effects of the ionic dissolution products of the quaternary Si-Sr-Zn-Mg-codoped CaP (TEs-CaP) or 45S5 Bioglass® (45S5 BG), both as mixtures and separately, on rat bone marrow-derived mesenchymal stem cells (rOMSCs & rMSCs) from osteoporotic and normal animals, using an MTT test and Alizarin Red S staining. The materials enhanced cell proliferation and osteogenic differentiation, especially the combination of the BG and TEs-CaP. Analysis by quantitative PCR and ELISA indicated that the expression of osteogenic-specific genes and proteins were elevated. These investigations suggest that the TEs-CaP and 45S5 BG operate synergistically to create an extracellular environment that promotes proliferation and terminal osteogenic differentiation of both osteoporotic and normal rMSCs.
Collapse
Affiliation(s)
- Xiao-Yi Chen
- Clinical Research Institute, Zhejiang Provincial People's Hospital, Hangzhou 310014, China
| | - San-Zhong Xu
- The First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310009, China
| | - Xuan-Wei Wang
- The First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310009, China
| | - Xian-Yan Yang
- Zhejiang-California International Nanosystems Institute, Zhejiang University, Hangzhou 310058, China
| | - Liang Ma
- Zhejiang-California International Nanosystems Institute, Zhejiang University, Hangzhou 310058, China
| | - Lei Zhang
- Rui'an People's Hospital & The 3rd Affiliated Hospital to Wenzhou Medical University, Rui'an 325005, China
| | - Guo-Jing Yang
- Rui'an People's Hospital & The 3rd Affiliated Hospital to Wenzhou Medical University, Rui'an 325005, China
| | - Fan Yang
- Clinical Research Institute, Zhejiang Provincial People's Hospital, Hangzhou 310014, China
| | - Lin-Hong Wang
- Clinical Research Institute, Zhejiang Provincial People's Hospital, Hangzhou 310014, China
| | - Xin-Li Zhang
- Dental and Craniofacial Research Institute, School of Dentistry, University of California, Los Angeles, CA 90095, USA
| | - Kang Ting
- Dental and Craniofacial Research Institute, School of Dentistry, University of California, Los Angeles, CA 90095, USA
| | - Chang-You Gao
- Zhejiang-California International Nanosystems Institute, Zhejiang University, Hangzhou 310058, China
| | - Xiao-Zhou Mou
- Clinical Research Institute, Zhejiang Provincial People's Hospital, Hangzhou 310014, China
| | - Zhong-Ru Gou
- Zhejiang-California International Nanosystems Institute, Zhejiang University, Hangzhou 310058, China
| | - Hai Zou
- Department of Cardiology, Zhejiang Provincial People's Hospital, Hangzhou 310014, China
| |
Collapse
|
7
|
van Gestel NAP, Hulsen DJW, Geurts J, Hofmann S, Ito K, Arts JJ, van Rietbergen B. Composition dependent mechanical behaviour of S53P4 bioactive glass putty for bone defect grafting. J Mech Behav Biomed Mater 2017; 69:301-306. [PMID: 28131065 DOI: 10.1016/j.jmbbm.2017.01.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/10/2017] [Accepted: 01/13/2017] [Indexed: 11/24/2022]
Abstract
To improve the handling properties of S53P4 bioactive glass granules for clinical applications, bioactive glass putty formulations were developed. These formulations contain both granules and a synthetic binder to form an injectable material that is easy to shape. To explore its applicability in load-bearing bone defect grafting, the relation between the putty composition and its mechanical behaviour was assessed in this study. Five putty formulations with variations in synthetic binder and granule content were mechanically tested in confined compression. The results showed that the impaction strains significantly decreased and the residual strains significantly increased with an increasing binder content. The stiffness of all tested formulations was found to be in the same range as the reported stiffness of cancellous bone. The measured creep strains were low and no significant differences between formulations were observed. The stiffness significantly increased when the samples were subjected to a second loading stage. The residual strains calculated from this second loading stage were also significantly different from the first loading stage, showing an increasing difference with an increasing binder content. Since residual strains are detrimental for graft layer stability in load-bearing defects, putty compositions with a low binder content would be most beneficial for confined, load-bearing bone defect grafting.
Collapse
Affiliation(s)
- N A P van Gestel
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands; Institute for Complex Molecular Systems, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands.
| | - D J W Hulsen
- Department of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, PO Box 5800, 6229 HX Maastricht, The Netherlands; MICT Department, Jeroen Bosch Ziekenhuis, PO Box 90153, 5200 ME 's-Hertogenbosch, The Netherlands
| | - J Geurts
- Department of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, PO Box 5800, 6229 HX Maastricht, The Netherlands
| | - S Hofmann
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands; Institute for Complex Molecular Systems, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands; Institute for Biomechanics, Swiss Federal Institute of Technology Zürich (ETHZ), Leopold-Ruzicka-Weg 4, 8093 Zürich, Switzerland
| | - K Ito
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands; Institute for Complex Molecular Systems, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands; Department of Orthopaedics, University Medical Centre Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - J J Arts
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands; Department of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, PO Box 5800, 6229 HX Maastricht, The Netherlands
| | - B van Rietbergen
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands; Department of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, PO Box 5800, 6229 HX Maastricht, The Netherlands.
| |
Collapse
|
8
|
Sarin J, Hiltunen M, Hupa L, Pulkkinen J, Vallittu PK. Compression properties and dissolution of bioactive glass S53P4 and n-butyl-2 cyanoacrylate tissue adhesive-composite. Biomed Mater Eng 2016; 27:425-436. [PMID: 27689575 DOI: 10.3233/bme-161596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Bioactive glass (BG)-containing fiber-reinforced composite implants, typically screw-retained, have started to be used clinically. In this study, we tested the mechanical strength of composites formed by a potential implant adhesive of n-butyl-2-cyanoacrylate glue and BG S53P4 particles. Water immersion for 3, 10 or 30 days had no adverse effect on the compression strength. When cyanoacrylate glue-BG-composites were subjected to simulated body fluid immersion, the average pH rose to 7.52 (SD 0.066) from the original value of 7.35 after 7 days, and this pH increment was smaller compared to BG particle-group or fibrin glue-BG-composite group. Based on these results n-butyl-2 cyanoacrylate glue, by potentially producing a strong adhesion, might be considered a possible alternative for fixation of BG S53P4 containing composite implants. However, the mechanical and solubility properties of the cyanoacrylate glue may not encourage the use of this tissue adhesive with BG particles.
Collapse
Affiliation(s)
- Jussi Sarin
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Markus Hiltunen
- BioCity, Turku Biomaterials Research Program, Turku Clinical Biomaterials Centre - TCBC, Finland
| | - Leena Hupa
- Process Chemistry Centre, Laboratory of Inorganic Chemistry, Åbo Akademi University, Finland
| | - Jaakko Pulkkinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Pekka K Vallittu
- BioCity, Turku Biomaterials Research Program, Turku Clinical Biomaterials Centre - TCBC, Finland.,Department of Biomaterials Science and Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, and City of Turku Welfare Division, Oral Health Care, Turku, Finland
| |
Collapse
|
9
|
Saçak B, Certel F, Akdeniz ZD, Karademir B, Ercan F, Özkan N, Akpinar İN, Çelebiler Ö. Repair of critical size defects using bioactive glass seeded with adipose-derived mesenchymal stem cells. J Biomed Mater Res B Appl Biomater 2016; 105:1002-1008. [PMID: 26888652 DOI: 10.1002/jbm.b.33634] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/15/2016] [Accepted: 01/20/2016] [Indexed: 12/25/2022]
Abstract
Bioactive glass has been demonstrated as a biocompatible bone substitute. However bone healing process can be prolonged due to late resorption of the material. Adipose derived stem cells (ASC) have osteogenic differentiation potential and hence can be a cell source for bone regeneration. The aim of this study was to test whether combination of bioactive glass with ASCs would enhance bone regeneration. Following creation of critical sized defects on the calvaria of 32 Wistar rats, the animals were randomly divided into four groups: Group C (control): Defects were left untreated; Group G: Defects were covered with autologous bone graft; Group BG: Defects were filled with bioactive glass; Group BG/ASC: Defects were filled with bioactive glass seeded with ASCs. The defect size was significantly greater in Group C compared to all other groups. Bone density was significantly lower in Group C compared to Group G and Group BG/ASC. Bone regeneration score of Group C was significantly lower than other groups. Group BG/ASC demonstrated lamellar bone and havers canal formation. The results of this study demonstrated that bioactive glass implanted with ASC is a biocompatible construct stimulating radiologically and histologically evident bone regeneration similar to autologous bone grafting. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1002-1008, 2017.
Collapse
Affiliation(s)
- Bülent Saçak
- Department of Plastic, Reconstructive and Aesthetic Surgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Furkan Certel
- Department of Plastic, Reconstructive and Aesthetic Surgery, Marmara University School of Medicine, Istanbul, Turkey.,Department of Plastic, Reconstructive and Aesthetic Surgery, Konya Teaching and Research Hospital, Konya, Turkey
| | - Zeynep D Akdeniz
- Department of Plastic, Reconstructive and Aesthetic Surgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Betül Karademir
- Department of Biochemistry, Marmara University School of Medicine, Istanbul, Turkey
| | - Feriha Ercan
- Department of Histology and Embryology, Marmara University School of Medicine, Istanbul, Turkey
| | - Naziye Özkan
- Department of Histology and Embryology, Marmara University School of Medicine, Istanbul, Turkey
| | - İhsan Nuri Akpinar
- Department of Radiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Özhan Çelebiler
- Department of Plastic, Reconstructive and Aesthetic Surgery, Marmara University School of Medicine, Istanbul, Turkey
| |
Collapse
|
10
|
Dubois L, Steenen S, Gooris P, Bos R, Becking A. Controversies in orbital reconstruction—III. Biomaterials for orbital reconstruction: a review with clinical recommendations. Int J Oral Maxillofac Surg 2016; 45:41-50. [DOI: 10.1016/j.ijom.2015.06.024] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 06/24/2015] [Accepted: 06/29/2015] [Indexed: 11/25/2022]
|
11
|
Clinical Applications of S53P4 Bioactive Glass in Bone Healing and Osteomyelitic Treatment: A Literature Review. BIOMED RESEARCH INTERNATIONAL 2015; 2015:684826. [PMID: 26504821 PMCID: PMC4609389 DOI: 10.1155/2015/684826] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 07/28/2015] [Indexed: 12/19/2022]
Abstract
Nowadays, S53P4 bioactive glass is indicated as a bone graft substitute in various clinical applications. This review provides an overview of the current published clinical results on indications such as craniofacial procedures, grafting of benign bone tumour defects, instrumental spondylodesis, and the treatment of osteomyelitis. Given the reported results that are based on examinations, such as clinical examinations by the surgeons, radiographs, CT, and MRI images, S53P4 bioactive glass may be beneficial in the various reported applications. Especially in craniofacial reconstructions like mastoid obliteration and orbital floor reconstructions, in grafting bone tumour defects, and in the treatment of osteomyelitis very promising results are obtained. Randomized clinical trials need to be performed in order to determine whether bioactive glass would be able to replace the current golden standard of autologous bone usage or with the use of antibiotic containing PMMA beads (in the case of osteomyelitis).
Collapse
|
12
|
Cortez PP, Brito AF, Kapoor S, Correia AF, Atayde LM, Dias‐Pereira P, Maurício AC, Afonso A, Goel A, Ferreira JM. The
in vivo
performance of an alkali‐free bioactive glass for bone grafting,
F
ast
O
s
®
BG
, assessed with an ovine model. J Biomed Mater Res B Appl Biomater 2015; 105:30-38. [DOI: 10.1002/jbm.b.33529] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 08/04/2015] [Accepted: 09/05/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Paulo P. Cortez
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS‐UP)4050‐313Porto Portugal
- Centro de Estudos de Ciência AnimalInstituto de Ciências e Tecnologias Agrárias e Agro‐Alimentares (CECA‐ICETA), Universidade do Porto4485‐661Vairão Portugal
| | - Ana F. Brito
- Reg4life − Regeneration TechnologyS.A., Biocant, Parque Tecnológico de Cantanhede3060‐197Cantanhede Portugal
| | - Saurabh Kapoor
- Departamento de Engenharia de Materiais e CerâmicaUniversidade de Aveiro (UA), CICECO3810‐193Aveiro Portugal
| | - Ana F. Correia
- Departamento de Engenharia de Materiais e CerâmicaUniversidade de Aveiro (UA), CICECO3810‐193Aveiro Portugal
| | - Luis M. Atayde
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS‐UP)4050‐313Porto Portugal
- Centro de Estudos de Ciência AnimalInstituto de Ciências e Tecnologias Agrárias e Agro‐Alimentares (CECA‐ICETA), Universidade do Porto4485‐661Vairão Portugal
| | - Patrícia Dias‐Pereira
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS‐UP)4050‐313Porto Portugal
| | - Ana Colette Maurício
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS‐UP)4050‐313Porto Portugal
- Centro de Estudos de Ciência AnimalInstituto de Ciências e Tecnologias Agrárias e Agro‐Alimentares (CECA‐ICETA), Universidade do Porto4485‐661Vairão Portugal
| | - Américo Afonso
- Faculdade de Medicina Dentária da Universidade do Porto (FMD‐UP)4200‐393Porto Portugal
| | - Ashutosh Goel
- Department of Materials Science and EngineeringRutgers, The State University of New JerseyPiscataway New Jersey08854‐8065
| | - José M.F. Ferreira
- Departamento de Engenharia de Materiais e CerâmicaUniversidade de Aveiro (UA), CICECO3810‐193Aveiro Portugal
| |
Collapse
|
13
|
Emerging developments in the use of bioactive glass for reconstruction of craniofacial bone. Br J Oral Maxillofac Surg 2015; 53:760-2. [PMID: 26060136 DOI: 10.1016/j.bjoms.2015.04.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 04/21/2015] [Indexed: 11/20/2022]
Abstract
For decades, researchers have investigated the use of bioactive glasses as synthetic substitutes for bone grafts that can bond with bone, and recent discoveries have shown that their clinical performance in osteoplastic and reconstructive surgery has exceeded that of traditional synthetic materials. Craniofacial reconstructions with bioactive glass were associated with good functional and aesthetic results with no donor-site morbidity, and the material's unique ability to inhibit bacterial growth was advantageous when used in dead spaces that were chronically infected. Treatment of large defects in the head and neck with these multifunctional biomaterials is a suitable alternative to conventional methods.
Collapse
|
14
|
Profeta AC, Huppa C. Bioactive-glass in Oral and Maxillofacial Surgery. Craniomaxillofac Trauma Reconstr 2015; 9:1-14. [PMID: 26889342 DOI: 10.1055/s-0035-1551543] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 01/24/2015] [Indexed: 10/23/2022] Open
Abstract
The use of synthetic materials to repair craniofacial defects is increasing today and will increase further in the future. Because of the complexity of the anatomy in the head and neck region, reconstruction and augmentation of this area pose a challenge to the surgeon. This review discusses key facts and applications of traditional reconstruction bone substitutes, also offering comparative information. It then describes the properties and clinical applications of bioactive-glass (B-G) and its variants in oral and maxillofacial surgery, and provides clinical findings. The discussion of each compound includes a description of its composition and structure, the advantages and shortcomings of the material, and its current uses in the field of osteoplastic and reconstructive surgery. With a better understanding of the available alloplastic implants, the surgeon can make a more informed decision as to which implant would be most suitable in a particular patient.
Collapse
Affiliation(s)
- Andrea Corrado Profeta
- Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Jena, Germany
| | - Christoph Huppa
- Department of Oral and Maxillofacial Surgery, King's College Hospital NHS Foundation Trust, Denmark Hill, London, United Kingdom
| |
Collapse
|
15
|
Abstract
LEARNING OBJECTIVES After studying this article, the participant should be able to: 1. Explain the epidemiology, anatomy, and pathophysiology of orbital floor fractures. 2. Select the optimal timing of--and understand the indications for-operative repair of orbital floor fractures. 3. List advantages and disadvantages of the surgical approaches and materials available for orbital floor reconstruction. 4. Identify special considerations in treating pediatric patients presenting with orbital floor fractures. SUMMARY This maintenance of certification module reviews the anatomy, pathophysiology, diagnosis, and management of orbital floor fractures in addition to special considerations for pediatric patients. The shows the evidence rating scale used for the literature review in creating this maintenance of certification article.
Collapse
|
16
|
Baino F, Vitale-Brovarone C. Bioceramics in ophthalmology. Acta Biomater 2014; 10:3372-97. [PMID: 24879312 DOI: 10.1016/j.actbio.2014.05.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 05/15/2014] [Accepted: 05/16/2014] [Indexed: 12/21/2022]
Abstract
The benefits of ceramics in biomedical applications have been universally appreciated as they exhibit an extraordinarily broad set of physico-chemical, mechanical and biological properties which can be properly tailored by acting on their composition, porosity and surface texture to increase their versatility and suitability for targeted healthcare applications. Bioceramics have traditionally been used for the repair of hard tissues, such as bone and teeth, mainly due to their suitable strength for load-bearing applications, wear resistance (especially alumina, zirconia and composites thereof) and, in some cases, bone-bonding ability (calcium orthophosphates and bioactive glasses). Bioceramics have been also applied in other medical areas, like ophthalmic surgery; although their use in such a context has been scientifically documented since the late 1700s, the potential and importance of ceramic ocular implants still seem to be underestimated and an exhaustive, critical assessment is currently lacking in the relevant literature. The present review aims to fill this gap by giving a comprehensive picture of the ceramic-based materials and implants that are currently used in ophthalmology and pointing out the strengths and weaknesses of the existing devices. A prospect for future research is also provided, highlighting the potential of new, smart bioceramics able to carry specific added values which could have a significant impact on the treatment of ocular diseases.
Collapse
|
17
|
Baino F. How can bioactive glasses be useful in ocular surgery? J Biomed Mater Res A 2014; 103:1259-75. [DOI: 10.1002/jbm.a.35260] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 05/29/2014] [Accepted: 05/31/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Francesco Baino
- Institute of Materials Physics and Engineering, Applied Science and Technology Department; Politecnico di Torino, Corso Duca degli Abruzzi 24 10129 Torino Italy
| |
Collapse
|
18
|
Baino F, Perero S, Ferraris S, Miola M, Balagna C, Verné E, Vitale-Brovarone C, Coggiola A, Dolcino D, Ferraris M. Biomaterials for orbital implants and ocular prostheses: overview and future prospects. Acta Biomater 2014; 10:1064-87. [PMID: 24342039 DOI: 10.1016/j.actbio.2013.12.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 11/29/2013] [Accepted: 12/09/2013] [Indexed: 12/21/2022]
Abstract
The removal of an eye is one of the most difficult and dramatic decisions that a surgeon must consider in case of severe trauma or life-threatening diseases to the patient. The philosophy behind the design of orbital implants has evolved significantly over the last 60 years, and the use of ever more appropriate biomaterials has successfully reduced the complication rate and improved the patient's clinical outcomes and satisfaction. This review provides a comprehensive picture of the main advances that have been made in the development of innovative biomaterials for orbital implants and ocular prostheses. Specifically, the advantages, limitations and performance of the existing devices are examined and critically compared, and the potential of new, smart and suitable biomaterials are described and discussed in detail to outline a forecast for future research directions.
Collapse
Affiliation(s)
- Francesco Baino
- Institute of Materials Physics and Engineering, Applied Science and Technology Department, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino, Italy.
| | - Sergio Perero
- Institute of Materials Physics and Engineering, Applied Science and Technology Department, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino, Italy; Istituto Superiore Mario Boella, Torino, Italy
| | - Sara Ferraris
- Institute of Materials Physics and Engineering, Applied Science and Technology Department, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino, Italy
| | - Marta Miola
- Institute of Materials Physics and Engineering, Applied Science and Technology Department, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino, Italy
| | - Cristina Balagna
- Institute of Materials Physics and Engineering, Applied Science and Technology Department, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino, Italy
| | - Enrica Verné
- Institute of Materials Physics and Engineering, Applied Science and Technology Department, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino, Italy
| | - Chiara Vitale-Brovarone
- Institute of Materials Physics and Engineering, Applied Science and Technology Department, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino, Italy
| | - Andrea Coggiola
- S.O.C. Oculistica, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Via Venezia 16, Alessandria, Italy
| | - Daniela Dolcino
- S.O.C. Oculistica, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Via Venezia 16, Alessandria, Italy
| | - Monica Ferraris
- Institute of Materials Physics and Engineering, Applied Science and Technology Department, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino, Italy
| |
Collapse
|
19
|
Gunn JM, Rekola J, Hirvonen J, Aho AJ. Comparison of the osteoconductive properties of three particulate bone fillers in a rabbit model: allograft, calcium carbonate (Biocoral®) and S53P4 bioactive glass. Acta Odontol Scand 2013; 71:1238-42. [PMID: 23294163 DOI: 10.3109/00016357.2012.757642] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM The aim of this study was to compare the osteoconductivity and suitability of three biomaterials used as particulate fillers; S53P4 bioactive glass, allogeneic fresh frozen bone and coral-derived calcium carbonate. MATERIALS AND METHODS Materials were implanted into drill-holes in the femoral condyles of adult rabbits. Follow-ups were performed at 3, 6, 12 and 24 weeks. Host-response, osteoconductivity, bonding and filler-effect were evaluated by SEM, EDXA and histology and histomorphometry to evaluate. RESULTS All three materials were found to be biocompatible and osteoconductive. Defects filled with allograft seemed to have more bone at 24 weeks, although no statistically significant difference in new bone growth was found. In earlier time points, coral, however, was observed to degrade more quickly, leaving more empty space in the defects, thus making it a less suitable filler for cavitary defects. CONCLUSION At all time points there was less filler material (i.e. biomaterial and new bone) in coral-filled defects than in BAG or allograft filled defects (p < 0.05).
Collapse
|
20
|
Gunarajah DR, Samman N. Biomaterials for repair of orbital floor blowout fractures: a systematic review. J Oral Maxillofac Surg 2013; 71:550-70. [PMID: 23422151 DOI: 10.1016/j.joms.2012.10.029] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Revised: 10/10/2012] [Accepted: 10/22/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the reported use and outcomes of implant materials used for the restoration of post-traumatic orbital floor defects in adults. MATERIALS AND METHODS A systematic search of the English literature was performed in the databases of PubMed, Cochrane Library, and EMBASE. The study selection process was adapted from the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, and 55 articles complied with the study inclusion criteria. The primary outcome measures were diplopia, enophthalmos, graft extrusion/displacement, and infection related to the graft material. The secondary outcome measures were infraorbital paresthesia, orbital dystopia, orbital soft tissue entrapment, and donor-site complications. RESULTS Of 55 articles, 41 (74.5%) evaluated were retrospective case series, 9 (16.4%) were retrospective case-control studies, 3 (5.5%) were controlled trials, and 2 (3.6%) were prospective case series. Autogenous graft materials were predominantly used in 19 studies, alloplastic materials were used in 33 studies, and the remaining 3 articles reported on allogeneic materials. Overall, 19 different types of implant materials were used in 2,483 patients. Of 827 patients with diplopia before surgery, 151 (18.3%) had diplopia postoperatively. Of 449 patients with enophthalmos before surgery, 134 (29.8%) had enophthalmos postoperatively. Only 2 patients (0.1%) and 14 patients (0.6%) had graft extrusion/displacement and infection related to the graft material, respectively; alloplastic biomaterials were used in all of these cases. CONCLUSIONS All graft materials used were successful to variable degrees because all studies reported improvement in terms of the recorded outcome measures. A guideline for choice of implant material based on defect size was developed.
Collapse
|
21
|
|
22
|
Sarin J, Grénman R, Aitasalo K, Pulkkinen J. Bioactive Glass S53P4 in Mastoid Obliteration Surgery for Chronic Otitis Media and Cerebrospinal Fluid Leakage. Ann Otol Rhinol Laryngol 2012; 121:563-9. [DOI: 10.1177/000348941212100901] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Objectives: We evaluated the results of cases of chronic otitis media treated with mastoid obliteration surgery using bioactive glass S53P4. Methods: Twenty-five patients with chronic otitis media and 1 patient with cerebrospinal fluid leakage without chronic infection were treated with bioactive glass S53P4. Twenty patients had had previous surgery because of chronic otitis media with or without cholesteatoma. A mastoid obliteration was performed with bioactive glass S53P4 granules and a musculoperiosteal flap with or without bone paté. In 2 patients with a bony dehiscence at the middle cranial fossa, a bioactive glass plate was used to support the protruding dura. In addition, in 3 patients, occlusion of a dural fistula was needed. The median follow-up period was 34.5 months (range, 1 to 182 months). Results: Excluding the 2 patients with only 1 month of follow-up at our department, 96% of the patients had a dry, safe ear or only intermittent otorrhea. In 92% of the patients, the objective of achieving a smaller or nonexistent cavity was achieved. Conclusions: Bioactive glass S53P4 is a noteworthy material in mastoid obliteration surgery.
Collapse
|
23
|
Abstract
The objectives of this study were (i) to evaluate different fracture mechanisms for orbital floor fractures and (ii) to measure forces and displacement of intraorbital tissue after orbital traumata to predict the necessity of strength for reconstruction materials. Six fresh frozen human heads were used, and orbital floor defects in the right and left orbit were created by a direct impact of 3.0 J onto the globe and infraorbital rim, respectively. Orbital floor defect sizes and displacement were evaluated after a Le Fort I osteotomy. In addition, after reposition of the intraorbital tissue, forces and displacement were measured. The orbital floor defect sizes were 208.3 (SD, 33.4) mm(2) for globe impact and 221.8 (SD, 53.1) mm(2) for infraorbital impact. The intraorbital tissue displacement after the impact and before reposition was 5.6 (SD, 1.0) mm for globe impact and 2.8 (SD, 0.7) mm for infraorbital impact. After reposition, the displacement was 0.8 (SD, 0.5) mm and 1.1 (SD, 0.7) mm, respectively. The measured applied forces were 0.061 (SD, 0.014) N for globe impact and 0.066 (SD, 0.022) N for infraorbital impact. Different fracture-inductive mechanisms are not reflected by the pattern of the fracture. The forces needed after reposition are minimal (~0.07 N), which may explain the success of PDS foils [poly-(p-dioxanone)] and collagen membranes as reconstruction materials.
Collapse
|
24
|
Abstract
The objective of this study was first to establish a method to measure forces and displacement of the orbital content in defects of the orbital floor in truncated fresh and unfixed heads and second to characterize reconstruction materials with regard to punctuation strength and compression.Orbital floor defects (10 × 20 mm and 15 × 20 mm; 3 mm behind the orbital rim) were prepared after Le Fort I osteotomy. The values of force and displacement were recorded in 6 freshly frozen human heads. In addition, the punctuation strength of 2 reconstruction materials (polydioxanone [PDS] foil and collagen membrane) was evaluated using a Zwick Z010 TN1 universal testing machine. The forces of the orbital content (28.41 [SD, 1.6] g) applied to the defects of 10 × 20 mm and 15 × 20 mm with an intact periorbita were 0.04 (SD, 0.003) N (0.0002 MPa) and 0.07 (SD, 0.02) N (0.0002 MPa), respectively, and with a split periorbita were 0.06 (SD, 0.03) N (0.0003 MPa) and 0.08 (SD, 0.06) N (0.00026 MPa), respectively. The displacement values without reconstruction materials of the 10 × 20-mm and 15 × 20-mm defects were 0.94 (SD, 0.7) mm and 1.2 (SD, 0.5) mm, respectively. The PDS foil could withstand forces of 118.9 (SD, 14.1) N (0.375 MPa), and the collagen membrane could withstand forces of 44.5 (SD, 5.3) N (0.14 MPa). This is the first study to report forces charging the orbital floor. The presented results support the use of PDS foils and collagen membranes as reconstruction materials for orbital floor defects, at least in smaller and medium-sized fractures.
Collapse
|
25
|
Biomaterials and implants for orbital floor repair. Acta Biomater 2011; 7:3248-66. [PMID: 21651997 DOI: 10.1016/j.actbio.2011.05.016] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 04/19/2011] [Accepted: 05/16/2011] [Indexed: 11/23/2022]
Abstract
Treatment of orbital floor fractures and defects is often a complex issue. Repair of these injuries essentially aims to restore the continuity of the orbital floor and to provide an adequate support to the orbital content. Several materials and implants have been proposed over the years for orbital floor reconstruction, in the hope of achieving the best clinical outcome for the patient. Autografts have been traditionally considered as the "gold standard" choice due to the absence of an adverse immunological response, but they are available in limited amounts and carry the need for extra surgery. In order to overcome the drawbacks related to autografts, researchers' and surgeons' attention has been progressively attracted by alloplastic materials, which can be commercially produced and easily tailored to fit a wide range of specific clinical needs. In this review the advantages and limitations of the various biomaterials proposed and tested for orbital floor repair are critically examined and discussed. Criteria and guidelines for optimal material/implant choice, as well as future research directions, are also presented, in an attempt to understand whether an ideal biomaterial already exists or a truly functional implant will eventually materialise in the next few years.
Collapse
|
26
|
Calori GM, Mazza E, Colombo M, Ripamonti C. The use of bone-graft substitutes in large bone defects: any specific needs? Injury 2011; 42 Suppl 2:S56-63. [PMID: 21752369 DOI: 10.1016/j.injury.2011.06.011] [Citation(s) in RCA: 264] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The gold standard for restoring bone defects is still considered to be autologous bone grafting. However, clinical benefits are not guaranteed and donor-site complications and morbidity is not infrequent. Research is on-going for the development of alternative bone substitutes of both biological and synthetic origin. The purpose of this study was to evaluate the type of materials used and their efficacy for the treatment of large bone defects in traumatology and orthopaedic surgery. MATERIALS AND METHOD A literature review was carried out of Embase and PubMed databases. Inclusion criteria were articles in English language focusing on the use of bone substitutes in trauma and orthopaedic surgery for the treatment of bone defects and included details on the structural, biological or biomechanical properties of the pure product. Furthermore, based on two clinical challenges, fracture non-union and impaction grafting we elaborated on the use of polytherapy for large bone defects as guided by the diamond concept. RESULTS All the products indicated in this manuscript possess osteoconductive activities but have different resorption times and biomechanical properties. Bone graft substitute materials are used for a wide range of clinical applications even when the level of clinical evidence is low. The size and location of the defect and the local biological and mechanical environment as well as the biomechanical characteristics of the material determine the type of device that can be implanted in a bone defect. CONCLUSION Proper assessment of the biological and mechanical environment and accurate patient selection are necessary to judge the extent of therapy the injury warrants. A sound understanding of various aspects of biomaterial properties and their relation and influence towards bone healing is of utmost importance. We suggest the application of polytherapy for the treatment of large bone defects and advocate the use of the diamond concept as a guideline.
Collapse
Affiliation(s)
- G M Calori
- COR, Orthopaedic Institute, G Pini, University of Milan, Italy.
| | | | | | | |
Collapse
|
27
|
Maier W. Biomaterials in skull base surgery. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2011; 8:Doc07. [PMID: 22073100 PMCID: PMC3199810 DOI: 10.3205/cto000059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Reconstruction materials and techniques for the base of the skull have undergone rapid developments and differentiation in recent years. While mostly autotransplants, collagens or resorbable alloplastic materials are preferred for duraplasties, pronounced organ-specific differences can be observed in the reconstruction of hard tissues. The use of polymethylmethacryl bone cement, once wide-spread, has decreased greatly due to the release of toxic monomers. Bony autotransplants are still used primarily for smaller skull-base defects, intraoperatively formable titanium nets may be also used for larger fronto- or laterobasal reconstructions of bony defects. Defects in visible areas are increasingly closed with preformed titanium or ceramic implants, which are planned and fitted to the individual patient using preoperative CT imaging. At the skull base, this applies especially to reconstructions of the frontal sinus. For extensive reconstructions of the orbita, titanium nets and non-resorbable plastics have proven valuable; in closing smaller defects especially of the orbital floor, resorbable implants based on Polyglactin 901 are also used.
Collapse
Affiliation(s)
- Wolfgang Maier
- Department of Otorhinolaryngology, University of Freiburg Medical School and Clinics, Freiburg, Germany
| |
Collapse
|
28
|
Tabrizi R, Ozkan TB, Mohammadinejad C, Minaee N. Orbital Floor Reconstruction. J Craniofac Surg 2010; 21:1142-6. [DOI: 10.1097/scs.0b013e3181e57241] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
29
|
Current Opinion in Otolaryngology & Head and Neck Surgery. Current world literature. Curr Opin Otolaryngol Head Neck Surg 2009; 17:326-31. [PMID: 19602933 DOI: 10.1097/moo.0b013e32832fa68b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|