1
|
Turostowski M, Rendenbach C, Herzog P, Ellinghaus A, Prates Soares A, Heiland M, Duda GN, Schmidt-Bleek K, Fischer H. Titanium vs PEO Surface-Modified Magnesium Plate Fixation in a Mandible Bone Healing Model in Sheep. ACS Biomater Sci Eng 2024; 10:4901-4915. [PMID: 39072479 PMCID: PMC11322917 DOI: 10.1021/acsbiomaterials.4c00602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/15/2024] [Accepted: 07/22/2024] [Indexed: 07/30/2024]
Abstract
Titanium plates are the current gold standard for fracture fixation of the mandible. Magnesium alloys such as WE43 are suitable biodegradable alternatives due to their high biocompatibility and elasticity modulus close to those of cortical bone. By surface modification, the reagibility of magnesium and thus hydrogen gas accumulation per time are further reduced, bringing plate fixation with magnesium closer to clinical application. This study aimed to compare bone healing in a monocortical mandibular fracture model in sheep with a human-standard size, magnesium-based, plasma electrolytic-oxidation (PEO) surface modified miniplate fixation system following 4 and 12 weeks. Bone healing was analyzed using micro-computed tomography and histological analysis with Movat's pentachrome and Giemsa staining. For evaluation of the tissue's osteogenic activity, polychrome fluorescent labeling was performed, and vascularization was analyzed using immunohistochemical staining for alpha-smooth muscle actin. Bone density and bone mineralization did not differ significantly between titanium and magnesium (BV/TV: T1: 8.74 ± 2.30%, M1: 6.83 ± 2.89%, p = 0.589 and T2: 71.99 ± 3.13%, M2: 68.58 ± 3.74%, p = 0.394; MinB: T1: 26.16 ± 9.21%, M1: 22.15 ± 7.99%, p = 0.818 and T2: 77.56 ± 3.61%, M2: 79.06 ± 4.46%, p = 0.699). After 12 weeks, minor differences were observed regarding bone microstructure, osteogenic activity, and vascularization. There was significance with regard to bone microstructure (TrTh: T2: 0.08 ± 0.01 mm, M2: 0.06 ± 0.01 mm; p = 0.041). Nevertheless, these differences did not interfere with bone healing. In this study, adequate bone healing was observed in both groups. Only after 12 weeks were some differences detected with larger trabecular spacing and more vessel density in magnesium vs titanium plates. However, a longer observational time with full resorption of the implants should be targeted in future investigations.
Collapse
Affiliation(s)
- Marta Turostowski
- Department
of Oral and Maxillofacial Surgery, Charité
− Universitätsmedizin Berlin, Corporate Member of the
Freie Universität Berlin, Humboldt-Universität zu Berlin
and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - Carsten Rendenbach
- Department
of Oral and Maxillofacial Surgery, Charité
− Universitätsmedizin Berlin, Corporate Member of the
Freie Universität Berlin, Humboldt-Universität zu Berlin
and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - Paulina Herzog
- Department
of Oral and Maxillofacial Surgery, Charité
− Universitätsmedizin Berlin, Corporate Member of the
Freie Universität Berlin, Humboldt-Universität zu Berlin
and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - Agnes Ellinghaus
- Julius
Wolff Institute, Berlin Institute of Health
at Charité − Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin 13353, Germany
| | - Ana Prates Soares
- Department
of Oral and Maxillofacial Surgery, Charité
− Universitätsmedizin Berlin, Corporate Member of the
Freie Universität Berlin, Humboldt-Universität zu Berlin
and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
- Julius
Wolff Institute, Berlin Institute of Health
at Charité − Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin 13353, Germany
| | - Max Heiland
- Department
of Oral and Maxillofacial Surgery, Charité
− Universitätsmedizin Berlin, Corporate Member of the
Freie Universität Berlin, Humboldt-Universität zu Berlin
and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - Georg N. Duda
- Julius
Wolff Institute, Berlin Institute of Health
at Charité − Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin 13353, Germany
| | - Katharina Schmidt-Bleek
- Julius
Wolff Institute, Berlin Institute of Health
at Charité − Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin 13353, Germany
| | - Heilwig Fischer
- Department
of Oral and Maxillofacial Surgery, Charité
− Universitätsmedizin Berlin, Corporate Member of the
Freie Universität Berlin, Humboldt-Universität zu Berlin
and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
- Center
for Musculoskeletal Surgery, Charité
− Universitätsmedizin Berlin, Corporate Member of the
Freie Universität Berlin, Humboldt-Universität zu Berlin
and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
- BIH
Charité Clinician Scientist Program, Berlin Institute of Health at Charité − Universitätsmedizin
Berlin, BIH Biomedical Innovation Academy, Charitéplatz 1 ,Berlin 10117, Germany
| |
Collapse
|
2
|
Ruf P, Orassi V, Fischer H, Steffen C, Kreutzer K, Duda GN, Heiland M, Checa S, Rendenbach C. Biomechanical evaluation of CAD/CAM magnesium miniplates as a fixation strategy for the treatment of segmental mandibular reconstruction with a fibula free flap. Comput Biol Med 2024; 168:107817. [PMID: 38064852 DOI: 10.1016/j.compbiomed.2023.107817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/21/2023] [Accepted: 12/03/2023] [Indexed: 01/10/2024]
Abstract
Titanium patient-specific (CAD/CAM) plates are frequently used in mandibular reconstruction. However, titanium is a very stiff, non-degradable material which also induces artifacts in the imaging. Although magnesium has been proposed as a potential material alternative, the biomechanical conditions in the reconstructed mandible under magnesium CAD/CAM plate fixation are unknown. This study aimed to evaluate the primary fixation stability and potential of magnesium CAD/CAM miniplates. The biomechanical environment in a one segmental mandibular reconstruction with fibula free flap induced by a combination of a short posterior titanium CAD/CAM reconstruction plate and two anterior CAD/CAM miniplates of titanium and/or magnesium was evaluated, using computer modeling approaches. Output parameters were the strains in the healing regions and the stresses in the plates. Mechanical strains increased locally under magnesium fixation. Two plate-protective constellations for magnesium plates were identified: (1) pairing one magnesium miniplate with a parallel titanium miniplate and (2) pairing anterior magnesium miniplates with a posterior titanium reconstruction plate. Due to their degradability and reduced stiffness in comparison to titanium, magnesium plates could be beneficial for bone healing. Magnesium miniplates can be paired with titanium plates to ensure a non-occurrence of plate failure.
Collapse
Affiliation(s)
- Philipp Ruf
- Julius Wolff Institute, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, 13353, Germany; Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, Berlin, 13353, Germany
| | - Vincenzo Orassi
- Julius Wolff Institute, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, 13353, Germany
| | - Heilwig Fischer
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, Berlin, 13353, Germany; Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Center for Musculoskeletal Surgery, Augustenburger Platz 1, Berlin, 13353, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Charitéplatz 1, Berlin, 10117, Germany
| | - Claudius Steffen
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, Berlin, 13353, Germany
| | - Kilian Kreutzer
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, Berlin, 13353, Germany
| | - Georg N Duda
- Julius Wolff Institute, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, 13353, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, Berlin, 13353, Germany
| | - Sara Checa
- Julius Wolff Institute, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.
| | - Carsten Rendenbach
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, Berlin, 13353, Germany
| |
Collapse
|
3
|
Antoniac I, Manescu (Paltanea) V, Antoniac A, Paltanea G. Magnesium-based alloys with adapted interfaces for bone implants and tissue engineering. Regen Biomater 2023; 10:rbad095. [PMID: 38020233 PMCID: PMC10664085 DOI: 10.1093/rb/rbad095] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 10/03/2023] [Accepted: 10/22/2023] [Indexed: 12/01/2023] Open
Abstract
Magnesium and its alloys are one of the most used materials for bone implants and tissue engineering. They are characterized by numerous advantages such as biodegradability, high biocompatibility and mechanical properties with values close to the human bone. Unfortunately, the implant surface must be adequately tuned, or Mg-based alloys must be alloyed with other chemical elements due to their increased corrosion effect in physiological media. This article reviews the clinical challenges related to bone repair and regeneration, classifying bone defects and presenting some of the most used and modern therapies for bone injuries, such as Ilizarov or Masquelet techniques or stem cell treatments. The implant interface challenges are related to new bone formation and fracture healing, implant degradation and hydrogen release. A detailed analysis of mechanical properties during implant degradation is extensively described based on different literature studies that included in vitro and in vivo tests correlated with material properties' characterization. Mg-based trauma implants such as plates and screws, intramedullary nails, Herbert screws, spine cages, rings for joint treatment and regenerative scaffolds are presented, taking into consideration their manufacturing technology, the implant geometrical dimensions and shape, the type of in vivo or in vitro studies and fracture localization. Modern technologies that modify or adapt the Mg-based implant interfaces are described by presenting the main surface microstructural modifications, physical deposition and chemical conversion coatings. The last part of the article provides some recommendations from a translational perspective, identifies the challenges associated with Mg-based implants and presents some future opportunities. This review outlines the available literature on trauma and regenerative bone implants and describes the main techniques used to control the alloy corrosion rate and the cellular environment of the implant.
Collapse
Affiliation(s)
- Iulian Antoniac
- Faculty of Material Science and Engineering, National University of Science and Technology POLITEHNICA Bucharest, 060042 Bucharest, Romania
- Academy of Romanian Scientists, 050094 Bucharest, Romania
| | - Veronica Manescu (Paltanea)
- Faculty of Material Science and Engineering, National University of Science and Technology POLITEHNICA Bucharest, 060042 Bucharest, Romania
- Faculty of Electrical Engineering, National University of Science and Technology POLITEHNICA Bucharest, 060042 Bucharest, Romania
| | - Aurora Antoniac
- Faculty of Material Science and Engineering, National University of Science and Technology POLITEHNICA Bucharest, 060042 Bucharest, Romania
| | - Gheorghe Paltanea
- Faculty of Electrical Engineering, National University of Science and Technology POLITEHNICA Bucharest, 060042 Bucharest, Romania
| |
Collapse
|
4
|
Ansoms P, Barzegari M, Vander Sloten J, Geris L. Coupling biomechanical models of implants with biodegradation models: A case study for biodegradable mandibular bone fixation plates. J Mech Behav Biomed Mater 2023; 147:106120. [PMID: 37757617 DOI: 10.1016/j.jmbbm.2023.106120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/05/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023]
Abstract
In fracture fixation, biodegradable implant materials are an interesting alternative to conventional non-biodegradable materials as the latter often require a second implant removal surgery to avoid long-term complications. In this study, we present an in silico strategy to design/study biodegradable metal implants focusing on mandibular fracture fixation plates of WE43 (Mg alloy). The in silico strategy is composed of an orchestrated interaction between three separate computational models. The first model simulates the mass loss of the degradable implant based on the chemistry of Mg biodegradation. A second model estimates the loading on the jaw plate in the physiological environment, incorporating a phenomenological dynamic bone regeneration process. The third model characterizes the mechanical behavior of the jaw plate and the influence of material degradation on the mechanical behavior. A sensitivity analysis was performed on parameters related to choices regarding numerical implementation and parameter dependencies were implemented to guarantee robust and correct results. Different clinical scenarios were tested, related to the amount of screws used to fix the plate. The results showed a lower initial strength when more screw holes were left open, as well as a faster decrease over time in strength due to the increased area available for surface degradation. The obtained degradation results were found to be in accordance with previously reported data of in vivo studies with biodegradable plates. The combination of these three models allows for the design of patient-specific biodegradable fixation implants able to deliver the desired mechanical behavior tuned to the bone regeneration process.
Collapse
Affiliation(s)
- Pieter Ansoms
- Biomechanics Section, Department of Mechanical Engineering, KU Leuven, Leuven, Belgium.
| | - Mojtaba Barzegari
- Biomechanics Section, Department of Mechanical Engineering, KU Leuven, Leuven, Belgium.
| | - Jos Vander Sloten
- Biomechanics Section, Department of Mechanical Engineering, KU Leuven, Leuven, Belgium.
| | - Liesbet Geris
- Biomechanics Section, Department of Mechanical Engineering, KU Leuven, Leuven, Belgium; Biomechanics Research Unit, GIGA in Silico Medicine, University of Liège, Belgium; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
| |
Collapse
|
5
|
Dryhval B, Husak Y, Sulaieva O, Deineka V, Pernakov M, Lyndin M, Romaniuk A, Simka W, Pogorielov M. In Vivo Safety of New Coating for Biodegradable Magnesium Implants. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5807. [PMID: 37687498 PMCID: PMC10488394 DOI: 10.3390/ma16175807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023]
Abstract
Biodegradable Magnesium (Mg) implants are promising alternatives to permanent metallic prosthesis. To improve the biocompatibility and with the aim of degradation control, we provided Plasma Electrolytic Oxidation (PEO) of pure Mg implant in silicate-based solution with NaOH (S1 250 V) and Ca(OH)2 (S2 300 V). Despite the well-structured surface, S1 250 V implants induced enormous innate immunity reaction with the prevalence of neutrophils (MPO+) and M1-macrophages (CD68+), causing secondary alteration and massive necrosis in the peri-implant area in a week. This reaction was also accompanied by systemic changes in visceral organs affecting animals' survival after seven days of the experiment. In contrast, S2 300 V implantation was associated with focal lymphohistiocytic infiltration and granulation tissue formation, defining a more favorable outcome. This reaction was associated with the prevalence of M2-macrophages (CD163+) and high density of αSMA+ myofibroblasts, implying a resolution of inflammation and effective tissue repair at the site of the implantation. At 30 days, no remnants of S2 300 V implants were found, suggesting complete resorption with minor histological changes in peri-implant tissues. In conclusion, Ca(OH)2-contained silicate-based solution allows generating biocompatible coating reducing toxicity and immunogenicity with appropriate degradation properties that make it a promising candidate for medical applications.
Collapse
Affiliation(s)
- Bohdan Dryhval
- Biomedical Research Centre, Sumy State University, R-Korsakova Street, 40007 Sumy, Ukraine; (B.D.); (Y.H.); (V.D.); (M.P.); (M.L.); (A.R.)
| | - Yevheniia Husak
- Biomedical Research Centre, Sumy State University, R-Korsakova Street, 40007 Sumy, Ukraine; (B.D.); (Y.H.); (V.D.); (M.P.); (M.L.); (A.R.)
- Faculty of Chemistry, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Oksana Sulaieva
- Medical Laboratory CSD, Vasylkivska Street, 45, 02000 Kyiv, Ukraine;
| | - Volodymyr Deineka
- Biomedical Research Centre, Sumy State University, R-Korsakova Street, 40007 Sumy, Ukraine; (B.D.); (Y.H.); (V.D.); (M.P.); (M.L.); (A.R.)
- Institute of Atomic Physics and Spectroscopy, University of Latvia, Jelgavas iela 3, LV-1004 Riga, Latvia
| | - Mykola Pernakov
- Biomedical Research Centre, Sumy State University, R-Korsakova Street, 40007 Sumy, Ukraine; (B.D.); (Y.H.); (V.D.); (M.P.); (M.L.); (A.R.)
| | - Mykola Lyndin
- Biomedical Research Centre, Sumy State University, R-Korsakova Street, 40007 Sumy, Ukraine; (B.D.); (Y.H.); (V.D.); (M.P.); (M.L.); (A.R.)
- Institute of Anatomy, Medical Faculty, University of Duisburg-Essen, 45147 Essen, Germany
| | - Anatolii Romaniuk
- Biomedical Research Centre, Sumy State University, R-Korsakova Street, 40007 Sumy, Ukraine; (B.D.); (Y.H.); (V.D.); (M.P.); (M.L.); (A.R.)
| | - Wojciech Simka
- Faculty of Chemistry, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Maksym Pogorielov
- Biomedical Research Centre, Sumy State University, R-Korsakova Street, 40007 Sumy, Ukraine; (B.D.); (Y.H.); (V.D.); (M.P.); (M.L.); (A.R.)
- Institute of Atomic Physics and Spectroscopy, University of Latvia, Jelgavas iela 3, LV-1004 Riga, Latvia
| |
Collapse
|
6
|
Sun J, Li Z, Liu S, Xia T, Shen J. Biodegradable magnesium screw, titanium screw and direct embedding fixation in pedicled vascularized iliac bone graft transfer for osteonecrosis of the femoral head: a randomized controlled study. J Orthop Surg Res 2023; 18:523. [PMID: 37481538 PMCID: PMC10363316 DOI: 10.1186/s13018-023-04012-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 07/14/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND The use of degradable magnesium screws to fix the bone flap implanted in the treatment of femoral head necrosis has achieved preliminary good therapeutic results. However, there is no conclusive evidence in the study to demonstrate whether biodegradable magnesium screws promote angiogenesis and no comparison has been made between degradable magnesium screws and traditional screws. OBJECTIVE To investigate the clinical efficacy and safety of biodegradable magnesium screws in pedicled vascularized iliac bone graft transfer (PVIBGT) for osteonecrosis of the femoral head (ONFH). MATERIALS AND METHODS A total of thirty-six patients (37 hips) with ONFH were recruited from March 2020 to July 2022. The study used a single-blind method, and patients who underwent PVIBGT were randomized into three groups: 12 patients (12 hips) were fixed with biodegradable magnesium screws (Group A), 12 patients (13 hips) were fixed with titanium screws (Group B), 12 patients (12 hips) were directly embedded (Group C). The operating time and the length of stay were recorded. Harris scores, radiological examinations (X-ray, CT, DCE-MRI), blood and serum tests were conducted before and after surgery. The gas yield and degradation rates of the magnesium screws were measured at the 3-months and 6-months post-operative follow-ups in Group A. RESULTS There was no statistically significant difference among these three groups in terms of types, gender, age, course of disease, surgical side, operation time, the length of stay (P > 0.05). All patients were followed up for 6 months. The mean Harris scores were higher in all groups 6 months after surgery (P < 0.05). The rates of excellent and good outcomes were 66.7%, 46.2%, and 33.3% in Groups A, B, and C, respectively. PVIBGT and magnesium screws can improve the blood supply of the femoral head via DCE-MRI evaluation. Two patients with poor incision healing received prompt treatment and subsequently recovered well. No adverse events, such as hip infection or deep vein thrombosis, were reported in the patients. The patients had good biocompatibility of magnesium screws, and no fracture of the magnesium screws was observed in Group A. Liver and kidney functions (including serum magnesium) were within normal ranges. The area of the intermuscular air space was 0 cm2 in follow-ups. The degradation rate of the biodegradable magnesium screws was approximately 10.32% at the 3-months follow-up and 13.72% at the 6-months follow-up. CONCLUSIONS PVIBGT has a positive effect, especially with regard to improving blood supply of the femoral head. The fixation of biodegradable magnesium screws is reliable and safe in PVIBGT, and promote angiogenesis.
Collapse
Affiliation(s)
- Jiahao Sun
- Department of Orthopaedics and Traumatology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, Jiangsu, China
| | - Zhipeng Li
- Department of Orthopaedics and Traumatology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, Jiangsu, China
| | - Shaowei Liu
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, Jiangsu, China
| | - Tianwei Xia
- Department of Orthopaedics and Traumatology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, Jiangsu, China.
| | - Jirong Shen
- Department of Orthopaedics and Traumatology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, Jiangsu, China.
| |
Collapse
|
7
|
Fischer H, Schmidt-Bleek O, Orassi V, Wulsten D, Schmidt-Bleek K, Heiland M, Steffen C, Rendenbach C. Biomechanical Comparison of WE43-Based Magnesium vs. Titanium Miniplates in a Mandible Fracture Model in Sheep. MATERIALS (BASEL, SWITZERLAND) 2022; 16:102. [PMID: 36614440 PMCID: PMC9821048 DOI: 10.3390/ma16010102] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/17/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
In fractures of the mandible, osteosynthesis with titanium plates is considered the gold standard. Titanium is an established and reliable material, its main disadvantages being metal artefacts and the need for removal in case of osteosynthesis complications. Magnesium, as a resorbable material with an elastic modulus close to cortical bone, offers a resorbable alternative osteosynthesis material, yet mechanical studies in mandible fracture fixation are still missing. The hypothesis of this study was that magnesium miniplates show no significant difference in the mechanical integrity provided for fracture fixation in mandible fractures under load-sharing indications. In a non-inferiority test, a continuous load was applied to a sheep mandible fracture model with osteosynthesis using either titanium miniplates of 1.0 mm thickness (Ti1.0), magnesium plates of 1.75 mm (Mg1.75), or magnesium plates of 1.5 mm thickness (Mg1.5). No significant difference (p > 0.05) was found in the peak force at failure, stiffness, or force at vertical displacement of 1.0 mm between Mg1.75, Mg1.5, and Ti1.0. This study shows the non-inferiority of WE43 magnesium miniplates compared to the clinical gold standard titanium miniplates.
Collapse
Affiliation(s)
- Heilwig Fischer
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
- Center for Musculoskeletal Surgery, Charité—Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Oskar Schmidt-Bleek
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Vincenzo Orassi
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin-Brandenburg School for Regenerative Therapies, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Dag Wulsten
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Katharina Schmidt-Bleek
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Claudius Steffen
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Carsten Rendenbach
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
| |
Collapse
|
8
|
Adam R, Antoniac I, Negoiță S, Moldovan C, Rusu E, Orban C, Tudorache S, Hârșovescu T. In Vivo Study of Local and Systemic Responses to Clinical Use of Mg-1Ca Bioresorbable Orthopedic Implants. Diagnostics (Basel) 2022; 12:1966. [PMID: 36010316 PMCID: PMC9406976 DOI: 10.3390/diagnostics12081966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/07/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Resorbable Mg-based implants represent a new direction in orthopedic surgery but have some drawbacks, such as their rapid biodegradation and increased rate of corrosion. Some in vitro studies hypothesized that tissue necrosis, incision dehiscence, risk of gas embolization in vital organs, interference with coagulation processes, and trophocyte viability impairment can occur. (2) Methods: We conducted an in vivo study on ten rabbit cases, in two groups; group one, consisting of six cases, received cylindrical implants of Mg-1Ca alloy in tibial intramedullary bone tissue. Group two, consisting of four cases, received Mg-1Ca parallelepiped implants, in the thigh muscular tissue. We recorded and compared weight (preoperatively and at 2, 4, and 6 weeks postoperatively), complete blood count, serum electrolytes, liver and kidney functional markers, and coagulation parameters, prior to and at 6 weeks after surgery. Local evolution was assessed radiologically and with tissue biopsies with complete pathology analysis. (3) Results: All biological markers and clinical evolution were favorable, showing good integration of the implants with none of the local or systemic signs of degradation. (4) Conclusions: Our study shows that the clinical use of Mg-1Ca bioresorbable alloys can be safe as none of the cited local or systemic complications have been identified.
Collapse
Affiliation(s)
- Răzvan Adam
- Department of Orthopedics and Traumatology, Elias Emergency University Hospital, 011461 Bucharest, Romania
- Department of First Aid and Disaster Medicine, Faculty of Medicine, Titu Maiorescu University of Buchrest, 040051 Bucharest, Romania
| | - Iulian Antoniac
- Faculty of Materials Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independetei, 060042 Bucharest, Romania
| | - Silviu Negoiță
- Department of Anesthesia and Intensive Care, Clinical University Emergency Hospital Elias, 17 Marasti Blvd., 011461 Bucharest, Romania
- Department of Anesthesia and Intensive Care, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Cosmin Moldovan
- Department of Clinical Sciences, General Surgery, Faculty of Medicine, Titu Maiorescu University of Buchrest, 040051 Bucharest, Romania
- Department of General Surgery, Witting Clinical Hospital, 010243 Bucharest, Romania
| | - Elena Rusu
- Department of Preclinical Sciences, Biochemistry, Faculty of Medicine, Titu Maiorescu University of Buchrest, 040051 Bucharest, Romania
| | - Carmen Orban
- Department of Anesthesia and Intensive Care, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Intensive Care Unit Department, Monza Oncology Hospital, 013812 Bucharest, Romania
| | - Sorin Tudorache
- Department of Preclinical Sciences, Anatomy and Embryology, Faculty of Medicine, Titu Maiorescu Univesity of Bucharest, 040051 Bucharest, Romania
| | - Tudor Hârșovescu
- Department of Preclinical Sciences, Anatomy and Embryology, Faculty of Medicine, Titu Maiorescu Univesity of Bucharest, 040051 Bucharest, Romania
| |
Collapse
|
9
|
Kochetkova T, Groetsch A, Indermaur M, Peruzzi C, Remund S, Neuenschwander B, Bellon B, Michler J, Zysset P, Schwiedrzik J. Assessing minipig compact jawbone quality at the microscale. J Mech Behav Biomed Mater 2022; 134:105405. [DOI: 10.1016/j.jmbbm.2022.105405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/21/2022] [Accepted: 07/26/2022] [Indexed: 10/16/2022]
|
10
|
Kozakiewicz M, Gabryelczak I. Bone Union Quality after Fracture Fixation of Mandibular Head with Compression Magnesium Screws. MATERIALS (BASEL, SWITZERLAND) 2022; 15:2230. [PMID: 35329682 PMCID: PMC8950275 DOI: 10.3390/ma15062230] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 02/13/2022] [Accepted: 03/15/2022] [Indexed: 12/22/2022]
Abstract
For some years now, fixation devices created with resorbable magnesium alloys for the mandibular head have been clinically available and are beginning to be used. It is thus valuable to evaluate the quality of unions in these cases. The aim of this study was radiological comparison of magnesium versus titanium open reduction and rigid fixations in the mandible condylar head. Thirty-one patients were treated for fractures of the mandibular head with magnesium WE43 alloy headless compression screws (diameter 2.3 mm) and, as a reference group, 29 patients were included with similar construction titanium screws (diameter 1.8 mm). The 12-month results of the treatment were evaluated by the texture analysis of CT. Near similar treatment results were found with magnesium screws in traditional titanium fixation. Magnesium screws result in a higher density of the bone structure in the mandibular head. Conclusions: The quantitative evaluation of bone union after surgical treatment of mandibular head fracture with magnesium compression headless screws indicates that stable consolidation was achieved. Undoubtedly, the resorption process of the screws was found to be incomplete after 12 months, evidenced by a marked densification of the bone structure at the fracture site.
Collapse
Affiliation(s)
- Marcin Kozakiewicz
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 Żeromskiego Str., 90-549 Lodz, Poland;
| | | |
Collapse
|
11
|
Orassi V, Fischer H, Duda GN, Heiland M, Checa S, Rendenbach C. In Silico Biomechanical Evaluation of WE43 Magnesium Plates for Mandibular Fracture Fixation. Front Bioeng Biotechnol 2022; 9:803103. [PMID: 35223813 PMCID: PMC8866862 DOI: 10.3389/fbioe.2021.803103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022] Open
Abstract
Titanium fixation devices are the gold standard for the treatment of mandibular fractures; however, they present serious limitations, such as non-degradability and generation of imaging artifacts. As an alternative, biodegradable magnesium alloys have lately drawn attention due to their biodegradability and biocompatibility. In addition, magnesium alloys offer a relatively high modulus of elasticity in comparison to biodegradable polymers, being a potential option to substitute titanium in highly loaded anatomical areas, such as the mandible. This study aimed to evaluate the biomechanical competence of magnesium alloy WE43 plates for mandibular fracture fixation in comparison to the clinical standard or even softer polymer solutions. A 3D finite element model of the human mandible was developed, and four different fracture scenarios were simulated, together with physiological post-operative loading and boundary conditions. In a systematic comparison, the material properties of titanium alloy Ti-6Al-4V, magnesium alloy WE43, and polylactic acid (PLA) were assigned to the fixation devices, and two different plate thicknesses were tested. No failure was predicted in the fixation devices for any of the tested materials. Moreover, the magnesium and titanium fixation devices induced a similar amount of strain within the healing regions. On the other hand, the PLA devices led to higher mechanical strains within the healing region. Plate thickness only slightly influenced the primary fixation stability. Therefore, magnesium alloy WE43 fixation devices seem to provide a suitable biomechanical environment to support mandibular fracture healing in the early stages of bone healing. Magnesium WE43 showed a biomechanical performance similar to clinically used titanium devices with the added advantages of biodegradability and radiopacity, and at the same time it showed a remarkably higher primary stability compared to PLA fixation devices, which appear to be too unstable, especially in the posterior and more loaded mandibular fracture cases.
Collapse
Affiliation(s)
- Vincenzo Orassi
- Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- Berlin-Brandenburg School for Regenerative Therapies, Berlin, Germany
| | - Heilwig Fischer
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Georg N. Duda
- Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Sara Checa
- Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- *Correspondence: Sara Checa,
| | - Carsten Rendenbach
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
12
|
Bai Y, Wang L, Zhao L, Lingling E, Yang S, Jia S, Wen N. Antibacterial and Antioxidant Effects of Magnesium Alloy on Titanium Dental Implants. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:6537676. [PMID: 35035523 PMCID: PMC8758302 DOI: 10.1155/2022/6537676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/07/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES In this study, a new type of dental implant by covering the surface of the titanium (Ti) implant with zinc-magnesium (Zn-Mg) alloy was designed, to study the antibacterial and antioxidant effects of Mg alloy on titanium (Ti) implants in oral implant restoration. METHODS Human gingival fibroblasts (HGFs), S. sanguinis, and F. nucleatum bacteria were used to detect the bioactivity and antibacterial properties of Mg alloy-coated Ti implants. In addition, B6/J mice implanted with different materials were used to further detect their antibacterial and antioxidant properties. RESULTS The results showed that Mg alloy could better promote the adhesion and proliferation and improve the alkaline phosphatase (ALP) activity of HGFs, which contributed to better improved stability of implant osseointegration. In addition, Mg alloy could better inhibit the proliferation of S. sanguinis, while no significant difference was found in the proliferation of F. nucleatum between the two implants. In the mouse model, the peripheral inflammatory reaction and oxidative stress of the Mg alloy implant were significantly lower than those of the Ti alloy implant. CONCLUSIONS Zn-Mg alloy-coated Ti implants could better inhibit the growth of Gram-positive bacteria in the oral cavity, inhibit oxidative stress, and facilitate the proliferation activity of HGFs and the potential of osteoblast differentiation, thus, better increasing the stability of implant osseointegration.
Collapse
Affiliation(s)
- Yang Bai
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Lin Wang
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Lisheng Zhao
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - E. Lingling
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Shuo Yang
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Shunyi Jia
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Ning Wen
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| |
Collapse
|
13
|
Wei X, Tang Z, Wu H, Zuo X, Dong H, Tan L, Wang W, Liu Y, Wu Z, Shi L, Wang N, Li X, Xiao X, Guo Z. Biofunctional magnesium-coated Ti6Al4V scaffolds promote autophagy-dependent apoptosis in osteosarcoma by activating the AMPK/mTOR/ULK1 signaling pathway. Mater Today Bio 2021; 12:100147. [PMID: 34704011 PMCID: PMC8523865 DOI: 10.1016/j.mtbio.2021.100147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/30/2021] [Accepted: 10/05/2021] [Indexed: 11/24/2022] Open
Abstract
The recurrence of osteosarcoma (OS) after reconstruction using Ti6Al4V prostheses remains a major problem in the surgical treatment of OS. Modification of the surfaces of Ti6Al4V prostheses with antitumor functions is an important strategy for improving therapeutic outcomes. Magnesium (Mg) coating has been shown to be multifunctional: it exhibits osteogenic and angiogenic properties and the potential to inhibit OS. In this study, we determined the proper concentration of released Mg2+ with respect to OS inhibition and biosafety and evaluated the anti-OS effects of Mg-coated Ti6Al4V scaffolds. We found that the release of Mg2+ during short-term and long-term degradation could significantly inhibit the proliferation and migration of HOS and 143B cells. Increased cell apoptosis and excessive autophagy were also observed, and further evidence of AMPK/mTOR/ULK1 signaling pathway activation was obtained both in vitro and in vivo, which suggested that the biofunctional scaffolds induce OS inhibition. Our study demonstrates the ability of an Mg coating to inhibit OS and may contribute to the further application of Mg-coated Ti6Al4V prostheses. Multifunctional Mg coating is considerable surface modification for Ti6Al4V prostheses. Mg2+ releasing by the scaffolds could significantly inhibit the proliferation and migration of OS cells. The biofunctional scaffolds could inhibit OS by activating autophagy-dependent apoptosis. The AMPK/mTOR/ULK-1 pathway was involved in autophagy-depended apoptosis induced by the scaffolds.
Collapse
Affiliation(s)
- X Wei
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Z Tang
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - H Wu
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - X Zuo
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - H Dong
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - L Tan
- Institute of Metal Research, Chinese Academy of Science, Shenyang, 110016, PR China
| | - W Wang
- Department of Immunology, State Key Laboratory of Cancer Biology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Y Liu
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Z Wu
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - L Shi
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - N Wang
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - X Li
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710038, PR China
| | - X Xiao
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Z Guo
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710038, PR China
| |
Collapse
|
14
|
Liebi M, Lutz-Bueno V, Guizar-Sicairos M, Schönbauer BM, Eichler J, Martinelli E, Löffler JF, Weinberg A, Lichtenegger H, Grünewald TA. 3D nanoscale analysis of bone healing around degrading Mg implants evaluated by X-ray scattering tensor tomography. Acta Biomater 2021; 134:804-817. [PMID: 34333163 DOI: 10.1016/j.actbio.2021.07.060] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/01/2021] [Accepted: 07/23/2021] [Indexed: 11/28/2022]
Abstract
The nanostructural adaptation of bone is crucial for its biocompatibility with orthopedic implants. The bone nanostructure also determines its mechanical properties and performance. However, the bone's temporal and spatial nanoadaptation around degrading implants remains largely unknown. Here, we present insights into this important bone adaptation by applying scanning electron microscopy, elemental analysis, and small-angle X-ray scattering tensor tomography (SASTT). We extend the novel SASTT reconstruction method and provide a 3D scattering reciprocal space map per voxel of the sample's volume. From this reconstruction, parameters such as the thickness of the bone mineral particles are quantified, which provide additional information on nanostructural adaptation of bone during healing. We selected a rat femoral bone and a degrading ZX10 magnesium implant as model system, and investigated it over the course of 18 months, using a sham as control. We observe that the bone's nanostructural adaptation starts with an initially fast interfacial bone growth close to the implant, which spreads by a re-orientation of the nanostructure in the bone volume around the implant, and is consolidated in the later degradation stages. These observations reveal the complex bulk bone-implant interactions and enable future research on the related biomechanical bone responses. STATEMENT OF SIGNIFICANCE: Traumatic bone injuries are among the most frequent causes of surgical treatment, and often require the placement of an implant. The ideal implant supports and induces bone formation, while being mechanically and chemically adapted to the bone structure, ensuring a gradual load transfer. While magnesium implants fulfill these requirements, the nanostructural changes during bone healing and implant degradation remain not completely elucidated. Here, we unveil these processes in rat femoral bones with ZX10 magnesium implants and show different stages of bone healing in such a model system.
Collapse
Affiliation(s)
- Marianne Liebi
- Department of Physics, Chalmers University of Technology, 41296 Gothenburg, Sweden; Paul Scherrer Institut, 5232 Villigen PSI, Switzerland; Center for X-ray Analytics, Swiss Federal Laboratories for Materials Science and Technology (Empa), 9014 St. Gallen, Switzerland.
| | | | | | - Bernd M Schönbauer
- Institute of Physics and Materials Science, University of Natural Resources and Life Science (BOKU), 1190 Vienna, Austria
| | - Johannes Eichler
- Department of Orthopaedics, Medical University Graz, 8010 Graz, Austria
| | | | - Jörg F Löffler
- Laboratory of Metal Physics and Technology, Department of Materials, ETH Zurich, 8093 Zurich, Switzerland
| | - Annelie Weinberg
- Department of Orthopaedics, Medical University Graz, 8010 Graz, Austria
| | - Helga Lichtenegger
- Institute of Physics and Materials Science, University of Natural Resources and Life Science (BOKU), 1190 Vienna, Austria
| | | |
Collapse
|
15
|
Pou-Álvarez P, Riveiro A, Nóvoa XR, Jin X, Del Val J, Comesaña R, Boutinguiza M, Lusquiños F, Jones JR, Pérez-Prado MT, Pou J. Laser-Guided Corrosion Control: A New Approach to Tailor the Degradation of Mg-Alloys. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2021; 17:e2100924. [PMID: 33760359 DOI: 10.1002/smll.202100924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Indexed: 06/12/2023]
Abstract
Despite corrosion being commonly seen as a problem to be avoided, applications such as batteries or biodegradable implants do benefit from corrosion-like phenomena. However, current strategies address corrosion control from a global perspective for a whole component, without considering local adaptations to functionality specifications or inhomogeneous environments. Here, a novel concept is presented: the local control and guidance of corrosion through a laser surface treatment. Immersion tests in saline solution of AZ31 magnesium alloy samples show degradation rates reduced up to 15 times with the treatment, owing to a fast passivation after the induced microstructural modifications. By controlling the treatment conditions, the degradation can be restricted to delimited regions and driven towards specific directions. The applicability of the method for the design of tailored degradation biomedical implants is demonstrated and uses for cathodic protection systems and batteries can also be anticipated.
Collapse
Affiliation(s)
- Pablo Pou-Álvarez
- Applied Physics Department, University of Vigo, E.E.I., Lagoas-Marcosende, Vigo, 36310, Spain
- Department of Materials, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
| | - Antonio Riveiro
- Materials Engineering, Applied Mechanics and Construction Department, University of Vigo, E.E.I., Lagoas-Marcosende, Vigo, 36310, Spain
| | - Xosé Ramón Nóvoa
- ENCOMAT group, University of Vigo, E.E.I., Lagoas-Marcosende, Vigo, 36310, Spain
| | - Xueze Jin
- IMDEA Materials Institute, C/Eric Kandel, 2, Getafe, Madrid, 28906, Spain
| | - Jesús Del Val
- Applied Physics Department, University of Vigo, E.E.I., Lagoas-Marcosende, Vigo, 36310, Spain
| | - Rafael Comesaña
- Materials Engineering, Applied Mechanics and Construction Department, University of Vigo, E.E.I., Lagoas-Marcosende, Vigo, 36310, Spain
| | - Mohamed Boutinguiza
- Applied Physics Department, University of Vigo, E.E.I., Lagoas-Marcosende, Vigo, 36310, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur) SERGAS-UVIGO, Estrada de Clara Campoamor, 341, Vigo, 36312, Spain
| | - Fernando Lusquiños
- Applied Physics Department, University of Vigo, E.E.I., Lagoas-Marcosende, Vigo, 36310, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur) SERGAS-UVIGO, Estrada de Clara Campoamor, 341, Vigo, 36312, Spain
| | - Julian R Jones
- Department of Materials, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
| | | | - Juan Pou
- Applied Physics Department, University of Vigo, E.E.I., Lagoas-Marcosende, Vigo, 36310, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur) SERGAS-UVIGO, Estrada de Clara Campoamor, 341, Vigo, 36312, Spain
| |
Collapse
|
16
|
Herber V, Okutan B, Antonoglou G, Sommer NG, Payer M. Bioresorbable Magnesium-Based Alloys as Novel Biomaterials in Oral Bone Regeneration: General Review and Clinical Perspectives. J Clin Med 2021; 10:jcm10091842. [PMID: 33922759 PMCID: PMC8123017 DOI: 10.3390/jcm10091842] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 02/07/2023] Open
Abstract
Bone preservation and primary regeneration is a daily challenge in the field of dental medicine. In recent years, bioresorbable metals based on magnesium (Mg) have been widely investigated due to their bone-like modulus of elasticity, their high biocompatibility, antimicrobial, and osteoconductive properties. Synthetic Mg-based biomaterials are promising candidates for bone regeneration in comparison with other currently available pure synthetic materials. Different alloys based on Mg were developed to fit clinical requirements. In parallel, advances in additive manufacturing offer the possibility to fabricate experimentally bioresorbable metallic porous scaffolds. This review describes the promising clinical results of resorbable Mg-based biomaterials for bone repair in osteosynthetic application and discusses the perspectives of use in oral bone regeneration.
Collapse
Affiliation(s)
- Valentin Herber
- Department of Dentistry and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria; (G.A.); (M.P.)
- Department of Orthopaedics and Traumatology, Medical University of Graz, Auenbruggerplatz 5/6, 8036 Graz, Austria; (B.O.); (N.G.S.)
- Correspondence:
| | - Begüm Okutan
- Department of Orthopaedics and Traumatology, Medical University of Graz, Auenbruggerplatz 5/6, 8036 Graz, Austria; (B.O.); (N.G.S.)
| | - Georgios Antonoglou
- Department of Dentistry and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria; (G.A.); (M.P.)
| | - Nicole G. Sommer
- Department of Orthopaedics and Traumatology, Medical University of Graz, Auenbruggerplatz 5/6, 8036 Graz, Austria; (B.O.); (N.G.S.)
| | - Michael Payer
- Department of Dentistry and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria; (G.A.); (M.P.)
| |
Collapse
|
17
|
Ma Z, Zhou M, Wang L, Cheng Q, Hong J. Establishment of Pulp Damage Repair Models in Miniature Pigs Using Diode Lasers. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:369-377. [PMID: 33885356 DOI: 10.1089/photob.2020.4959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: To establish a controlled pulp damage repair model in miniature pigs by using a diode laser. Background: Laser is a novel kind of controllable energy, and it is widely used in dentistry. Methods: The premolars of four 24- to 28-month-old miniature pigs were divided into three laser groups, according to the output powers of a diode laser, and the nonirradiated first molars acted as controls. The teeth in laser groups were irradiated under three parameters (output powers 1.5, 2.5, 4 W, continuous wave, frequency 50 Hz for 60 sec). The dental and gingival morphology was observed at 0, 7, 14, and 21 days after laser irradiation. The animals were sacrificed for qualitative and quantitative pulp histopathological analysis. Results: The three laser groups present no seriously irreversible dental and gingival damage. In the 1.5-W group, dental pulp exhibited angiectasis and hyperemia with no inflammation, and did not significantly differ with the control groups at 21 days (p > 0.05). In the 2.5-W group, pulpal inflammation was highest at 7 days and then decreased significantly at 21 days, and the tissue repair appeared at 14 days (p < 0.05). In the 4-W group, pulpal inflammation was significantly highest at 7 days, with an increase in the degree of tissue repair (p < 0.05). Conclusions: The output power of 1.5 W developed a reversible pulpitis model; the output powers of 2.5 and 4 W within 7 days led to the development of irreversible pulpitis models, which proceeded as chronic pulpitis with obvious tissue repair.
Collapse
Affiliation(s)
- Zhifei Ma
- Stomatology Special Consultation Clinic, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - Mengqi Zhou
- National Clinical Research Center for Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China.,Department of Second Dental Clinic, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lizhen Wang
- National Clinical Research Center for Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China.,Department of Oral Pathology, and Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Cheng
- National Clinical Research Center for Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China.,Department of Endodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jin Hong
- Stomatology Special Consultation Clinic, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| |
Collapse
|
18
|
Rahmati M, Stötzel S, Khassawna TE, Iskhahova K, Florian Wieland DC, Zeller Plumhoff B, Haugen HJ. Early osteoimmunomodulatory effects of magnesium-calcium-zinc alloys. J Tissue Eng 2021; 12:20417314211047100. [PMID: 34589198 PMCID: PMC8474317 DOI: 10.1177/20417314211047100] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/01/2021] [Indexed: 01/04/2023] Open
Abstract
Today, substantial attention is given to biomaterial strategies for bone regeneration, and among them, there is a growing interest in using immunomodulatory biomaterials. The ability of a biomaterial to induce neo vascularization and macrophage polarization is a major factor in defining its success. Magnesium (Mg)-based degradable alloys have attracted significant attention for bone regeneration owing to their biodegradability and potential for avoiding secondary removal surgeries. However, there is insufficient evidence in the literature regarding the early inflammatory responses to these alloys in vivo. In this study, we investigated the early body responses to Mg-0.45wt%Zn-0.45wt%Ca pin-shaped alloy (known as ZX00 alloy) in rat femora 2, 5, and 10 days after implantation. We used 3D micro computed tomography (µCT), histological, immunohistochemical, histomorphometrical, and small angle X-ray scattering (SAXS) analyses to study new bone formation, early macrophage polarization, neo vascularization, and bone quality at the implant bone interface. The expression of macrophage type 2 biological markers increased significantly after 10 days of Mg alloy implantation, indicating its potential in stimulating macrophage polarization. Our biomineralization results using µCT as well as histological stained sections did not indicate any statistically significant differences between different time points for both groups. The activity of alkaline phosphatase (ALP) and Runt-related transcription factor 2 (Runx 2) biological markers decreased significantly for Mg group, indicating less osteoblast activity. Generally, our results supported the potential of ZX00 alloy to enhance the expression of macrophage polarization in vivo; however, we could not observe any statistically significant changes regarding biomineralization.
Collapse
Affiliation(s)
- Maryam Rahmati
- Department of Biomaterials, Institute
for Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Sabine Stötzel
- Experimental Trauma Surgery,
Justus-Liebig University Giessen, Giessen, Germany
| | - Thaqif El Khassawna
- Experimental Trauma Surgery,
Justus-Liebig University Giessen, Giessen, Germany
- Faculty of Health Sciences, University
of Applied Sciences, Giessen, Germany
| | - Kamila Iskhahova
- Institute of Metallic Biomaterials,
Helmholtz-Zentrum Hereon, Geesthacht, Germany
| | - DC Florian Wieland
- Institute of Metallic Biomaterials,
Helmholtz-Zentrum Hereon, Geesthacht, Germany
| | | | - Håvard Jostein Haugen
- Department of Biomaterials, Institute
for Clinical Dentistry, University of Oslo, Oslo, Norway
| |
Collapse
|
19
|
Zhang J, Shang Z, Jiang Y, Zhang K, Li X, Ma M, Li Y, Ma B. Biodegradable metals for bone fracture repair in animal models: a systematic review. Regen Biomater 2020; 8:rbaa047. [PMID: 33732493 PMCID: PMC7947587 DOI: 10.1093/rb/rbaa047] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/27/2020] [Accepted: 09/16/2020] [Indexed: 12/19/2022] Open
Abstract
Biodegradable metals hold promises for bone fracture repair. Their clinical translation requires pre-clinical evaluations including animal studies, which demonstrate the safety and performance of such materials prior to clinical trials. This evidence-based study investigates and analyzes the performance of bone fractures repair as well as degradation properties of biodegradable metals in animal models. Data were carefully collected after identification of population, interventions, comparisons, outcomes and study design, as well as inclusion criteria combining biodegradable metals and animal study. Twelve publications on pure Mg, Mg alloys and Zn alloys were finally included and reviewed after extraction from a collected database of 2122 publications. Compared to controls of traditional non-degradable metals or resorbable polymers, biodegradable metals showed mixed or contradictory outcomes of fracture repair and degradation in animal models. Although quantitative meta-analysis cannot be conducted because of the data heterogeneity, this systematic review revealed that the quality of evidence for biodegradable metals to repair bone fractures in animal models is 'very low'. Recommendations to standardize the animal studies of biodegradable metals were proposed. Evidence-based biomaterials research could help to both identify reliable scientific evidence and ensure future clinical translation of biodegradable metals for bone fracture repair.
Collapse
Affiliation(s)
- Jiazhen Zhang
- State Key Laboratory of Nonferrous Metals and Process, GRINM Group Corporation Limited (GRINM), No. 2, XinJieKouWai St., HaiDian District, Beijing 100088, P.R. China.,GRIMAT Engineering Institute Co., Ltd, No. 11, Xingke East St., Yanqi Economic Development Zone, Huairou District, Beijing 101407, P.R. China.,General Research Institute for Nonferrous Metals, No. 2, XinJieKouWai St., HaiDian District, Beijing 100088, P.R. China
| | - Zhizhong Shang
- School of Basic Medical Sciences, Evidence-Based Medicine Center, Lanzhou University, No 199, Donggang West Road, Chengguan District, Lanzhou 730000, P. R. China
| | - Yanbiao Jiang
- School of Basic Medical Sciences, Evidence-Based Medicine Center, Lanzhou University, No 199, Donggang West Road, Chengguan District, Lanzhou 730000, P. R. China
| | - Kui Zhang
- State Key Laboratory of Nonferrous Metals and Process, GRINM Group Corporation Limited (GRINM), No. 2, XinJieKouWai St., HaiDian District, Beijing 100088, P.R. China.,GRIMAT Engineering Institute Co., Ltd, No. 11, Xingke East St., Yanqi Economic Development Zone, Huairou District, Beijing 101407, P.R. China.,General Research Institute for Nonferrous Metals, No. 2, XinJieKouWai St., HaiDian District, Beijing 100088, P.R. China
| | - Xinggang Li
- State Key Laboratory of Nonferrous Metals and Process, GRINM Group Corporation Limited (GRINM), No. 2, XinJieKouWai St., HaiDian District, Beijing 100088, P.R. China.,GRIMAT Engineering Institute Co., Ltd, No. 11, Xingke East St., Yanqi Economic Development Zone, Huairou District, Beijing 101407, P.R. China.,General Research Institute for Nonferrous Metals, No. 2, XinJieKouWai St., HaiDian District, Beijing 100088, P.R. China
| | - Minglong Ma
- State Key Laboratory of Nonferrous Metals and Process, GRINM Group Corporation Limited (GRINM), No. 2, XinJieKouWai St., HaiDian District, Beijing 100088, P.R. China.,GRIMAT Engineering Institute Co., Ltd, No. 11, Xingke East St., Yanqi Economic Development Zone, Huairou District, Beijing 101407, P.R. China.,General Research Institute for Nonferrous Metals, No. 2, XinJieKouWai St., HaiDian District, Beijing 100088, P.R. China
| | - Yongjun Li
- State Key Laboratory of Nonferrous Metals and Process, GRINM Group Corporation Limited (GRINM), No. 2, XinJieKouWai St., HaiDian District, Beijing 100088, P.R. China.,GRIMAT Engineering Institute Co., Ltd, No. 11, Xingke East St., Yanqi Economic Development Zone, Huairou District, Beijing 101407, P.R. China.,General Research Institute for Nonferrous Metals, No. 2, XinJieKouWai St., HaiDian District, Beijing 100088, P.R. China
| | - Bin Ma
- School of Basic Medical Sciences, Evidence-Based Medicine Center, Lanzhou University, No 199, Donggang West Road, Chengguan District, Lanzhou 730000, P. R. China
| |
Collapse
|