Bone ingrowth in bFGF-coated hydroxyapatite ceramic implants

3D Bioprinting of Polycaprolactone-Based Scaffolds for Pulp-Dentin Regeneration: Investigation of Physicochemical and Biological Behavior

In this study, two structurally different scaffolds, a polycaprolactone (PCL)/45S5 Bioglass (BG) composite and PCL/hyaluronic acid (HyA) were fabricated by 3D printing technology and were evaluated for the regeneration of dentin and pulp tissues, respectively. Their physicochemical characterization was performed by field emission scanning electron microscopy (FESEM) equipped with energy dispersive spectroscopy (EDS), Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), atomic force microscopy (AFM), contact angle, and compressive strength tests. The results indicated that the presence of BG in the PCL/BG scaffolds promoted the mechanical properties, surface roughness, and bioactivity. Besides, a surface treatment of the PCL scaffold with HyA considerably increased the hydrophilicity of the scaffolds which led to an enhancement in cell adhesion. Furthermore, the gene expression results showed a significant increase in expression of odontogenic markers, e.g., dentin sialophosphoprotein (DSPP), osteocalcin (OCN), and dentin matrix protein 1 (DMP-1) in the presence of both PCL/BG and PCL/HyA scaffolds. Moreover, to examine the feasibility of the idea for pulp-dentin complex regeneration, a bilayer PCL/BG-PCL/HyA scaffold was successfully fabricated and characterized by FESEM. Based on these results, it can be concluded that PCL/BG and PCL/HyA scaffolds have great potential for promoting hDPSC adhesion and odontogenic differentiation.

Poly (Glycerol Sebacate)-Based Bio-Artificial Multiporous Matrix for Bone Regeneration

In recent years, bone repair biomaterials that combine cells and bioactive factors are superior to autologous and allogeneic bone implants. However, neither natural nor synthetic biomaterials can possess all desired qualities such as strength, porosity, and biological activity. In this study, we used poly (glycerol sebacate) (PGS), a synthetic material with great osteogenic potential that has attracted more attention in the field of tissue (such as bone tissue) regeneration owing to its good biocompatibility and high elasticity. It also has the advantage of being regulated by material synthesis to match the bone tissue's strength and can be easily modified to become functional. However, pure PGS lacks functional groups and hydrophilicity. Therefore, we used PGS as the substrate to graft the adhesive ligands RGD and vascular endothelial growth factor mimetic peptide. The bone repair scaffold can be prepared through photo crosslinking, as it not only improves hydrophobicity but also promotes vascularization and accelerates osteogenesis. Simultaneously, we improved the preparation method of hydrogels after freeze-drying and crosslinking to form a sponge-like structure and to easily regenerate blood vessels. In summary, a bone repair scaffold was prepared to meet the structural and biological requirements. It proved to serve as a potential bone-mimicking scaffold by enhancing tissue regenerative processes such as cell infiltration and vascularization and subsequent replacement by the native bone tissue.

Study of the osteogenesis effect of icariside II and icaritin on canine bone marrow mesenchymal stem cells

This study aimed to identify the osteogenesis effect of icariside II (ICSII) and icaritin (ICT) in vitro. Bone marrow mesenchymal stem cells (BMSCs) were treated with ICSII and ICT in order to detect the proliferation and differentiation of BMSCs, the expression of the osteogenesis-related proteins with or without osteogenic medium (OM) and genes, Runt-related transcription factor 2 (Runx-2), osteocalcin (OCN), osteopontin (OPN), osterix, and basic fibroblast growth factor (bFGF), and the phosphorylation levels of mitogen-activated protein kinase (MAPK). We found that the optical density increased and alkaline phosphatase decreased after the BMSCs were treated with different concentrations of ICSII; however, ICT showed an opposing effect. The formation of calcium nodules was observed after the BMSCs were treated with ICSII and ICT. The expression level of osteogenesis-related proteins was enhanced following treatment with both ICSII or ICT, while the expression level of the osteogenesis-related genes Runx-2, OCN, OPN, osterix, and bFGF significantly increased with ICSII treatment (P < 0.05), and only Runx-2 and bFGF significantly increased (P < 0.01) with ICT. The expression of osteogenic differentiation-related proteins (except OPN) following treatment with ICSII + OM or ICT + OM was not notably increased. Both ICSII and ICT elevated the phosphorylation levels of MAPK/ERK, which was attenuated by GDC-0994 (an inhibitor of MAPK/ERK). Collectively, these data indicate that ICSII and ICT facilitate orientation osteogenic differentiation of BMSCs, which is most likely via the MAPK/ERK pathway. OM did not synergistically enhance the osteogenesis effect of ICSII and ICT.

Magnetic silk fibroin e-gel scaffolds for bone tissue engineering applications

Recently, the incorporation of magnetic nanoparticles into standard scaffolds has emerged as a promising approach for tissue engineering applications. This strategy can promote not only tissue regeneration but also reloading of scaffolds through an external supervising center that adsorbs growth factors, preserving their stability and biological activity. In this study, novel magnetic silk fibroin e-gel scaffolds were prepared by the electrogelation process of concentrated Bombyx mori silk fibroin (8 wt%) aqueous solution. In addition, basic fibroblast growth factor was conjugated physically to human serum albumin = Fe3O4 nanoparticles (71.52 ± 2.3 nm in size) with 97.5% binding yield. Scanning electron microscopy images of the prepared human serum albumin = Fe3O4-basic fibroblast growth factor-loaded silk fibroin e-gel scaffolds showed a three-dimensional porous morphology. In terms of water uptake, basic fibroblast growth factor-conjugated scaffolds had the highest water absorbability among all groups. In vitro cell culture studies showed that both the human serum albumin coating of Fe3O4 nanoparticle surface and basic fibroblast growth factor conjugation had an inductive effect on cell viability. One of the most used markers of bone formation and osteoblast differentiation is alkaline phosphatase activity; human serum albumin = Fe3O4-basic fibroblast growth factor-loaded silk fibroin e-gels showed significantly enhanced alkaline phosphatase activity (p < 0.05). SaOS-2 cells cultured on human serum albumin = Fe3O4-basic fibroblast growth factor-loaded silk fibroin e-gels deposited more calcium compared with those cultured on bare silk fibroin e-gels. These results indicated that the proposed e-gel scaffolds are valuable candidates for magnetic guiding in bone tissue regeneration, and they will present new perspectives for magnetic field application in regenerative medicine.

Bone in Growth in bFGF Versus BMP Combined with bFGF Saturated PLA-PEG-PLA: Experiment in Surgically Created Rabbit Mandibular Defects

A triblock polymer of LPLA and PEG 1000 and 3400 at 3% and 9% was formed by ring opening under nitrogen atmosphere at 120°C and then, in one group, bFGF was added, while in the other both bFGF and BMP were added, leaving one group as a control. Gross, radiographic, histological and scanning electronic microscope observations were done. With the help of motic images advanced 3.0 new bone formed, calculated as a percentage of total selected area and, using SAS6.12, results were analyzed. Statistical analysis between groups showed that, at 2 weeks, the PLA-PEG-PLA + bFGF + BMP group had the highest amount of new bone formation, as a percentage of new bone over total surface area, at 48% followed by the PLA-PEG-PLA + bFGF group at 39%, then the PLA-PEG-PLA=BMP group at 29%. The PLA-PEGPLA group trailed in at 18% (statistical significance, p <0.05=0.0001). After 4 weeks, the experimental groups B and D had almost equal new bone formation (62% and 64% respectively), but still significantly different from the control group and BMP2 group, with 43% and 38% respectively ( p <0.05=0.0001). After 8 weeks, there was no difference in the amount of bone regeneration ( p >0.05=0.87).

Within the groups, the control group exhibited steady incremental new bone formation at 2, 4 and 8 weeks, starting out at 18%, followed by 42% and lastly 65%. Interestingly this phenomenon also applied to group C (BMP2 group) but not to the B group (bFGF group). The differences at the respective consecutive time of examination were statistically significant ( p <0.05=0.0001). However, in both experimental groups B and D there was statistically significant difference between new bone formed at 2 weeks compared to that at 4 weeks, but thereafter the increment was negligible.

Bone augmentation using a highly porous PLGA/β-TCP scaffold containing fibroblast growth factor-2

BACKGROUND AND OBJECTIVE

Beta-tricalcium phosphate (β-TCP), a bio-absorbable ceramic, facilitates bone conductivity. We constructed a highly porous three-dimensional scaffold, using β-TCP, for bone tissue engineering and coated it with co-poly lactic acid/glycolic acid (PLGA) to improve the mechanical strength and biological performance. The aim of this study was to examine the effect of implantation of the PLGA/β-TCP scaffold loaded with fibroblast growth factor-2 (FGF-2) on bone augmentation.

MATERIAL AND METHODS

The β-TCP scaffold was fabricated by the replica method using polyurethane foam, then coated with PLGA. The PLGA/β-TCP scaffold was characterized by scanning electron miscroscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction, compressive testing, cell culture and a subcutaneous implant test. Subsequently, a bone-forming test was performed using 52 rats. The β-TCP scaffold, PLGA-coated scaffold, and β-TCP and PLGA-coated scaffolds loaded with FGF-2, were implanted into rat cranial bone. Histological observations were made at 10 and 35 d postsurgery.

RESULTS

SEM and TEM observations showed a thin PLGA layer on the β-TCP particles after coating. High porosity (> 90%) of the scaffold was exhibited after PLGA coating, and the compressive strength of the PLGA/β-TCP scaffold was six-fold greater than that of the noncoated scaffold. Good biocompatibility of the PLGA/β-TCP scaffold was found in the culture and implant tests. Histological samples obtained following implantation of PLGA/β-TCP scaffold loaded with FGF-2 showed significant bone augmentation.

CONCLUSION

The PLGA coating improved the mechanical strength of β-TCP scaffolds while maintaining high porosity and tissue compatibility. PLGA/β-TCP scaffolds, in combination with FGF-2, are bioeffective for bone augmentation.

Preparation of laminated poly(ε-caprolactone)-gelatin-hydroxyapatite nanocomposite scaffold bioengineered via compound techniques for bone substitution

In this research, new bioactive nanocomposite scaffolds were successfully developed using poly(ε-caprolactone) (PCL), cross-linked gelatin and nanoparticles of hydroxyapatite (HAp) after testing different solvents and methods. First, HAp powder was synthesized via a chemical precipitation technique and characterized. Then, the nanocomposites were prepared through layer solvent casting combined with freeze-drying and lamination techniques. According to the results, the increasing of the PCL weight in the scaffolds led to the improvement of the mechanical properties. The amount of ultimate stress, stiffness and also elastic modulus increased from 8 MPa for 0% wt PCL to 23.5 MPa for 50% wt PCL. The biomineralization study revealed the formation of an apatite layer on the scaffolds after immersion in simulated body fluid (SBF). The Ca-P ratios were in accordance to nonstoichiometric biological apatite, which was approximately 1.67. The in vitro biocompatibility and cytocompatibility of the scaffolds were tested using mesenchymal stem cells (MSCs), and the results indicated no sign of toxicity, and cells were found to be attached to the scaffold walls. The in vivo biocompatibility and osteogenesis of these scaffolds in the animal experiments is also under investigation, and the result will be published at the end of the study.

Dual delivery of BMP-2 and bFGF from a new nano-composite scaffold, loaded with vascular stents for large-size mandibular defect regeneration

The aim of this study was to investigate the feasibility and advantages of the dual delivery of bone morphogenetic protein-2 (BMP-2) and basic fibroblast growth factor (bFGF) from nano-composite scaffolds (PLGA/PCL/nHA) loaded with vascular stents (PLCL/Col/nHA) for large bone defect regeneration in rabbit mandibles. Thirty-six large bone defects were repaired in rabbits using engineering bone composed of allogeneic bone marrow mesenchymal stem cells (BMSCs), bFGF, BMP-2 and scaffolds composed of PLGA/PCL/nHA loaded with PLCL/Col/nHA. The experiments were divided into six groups: BMSCs/bFGF/BMP-2/scaffold, BMSCs/BMP-2/scaffold, BMSCs/bFGF/scaffold, BMSCs/scaffold, scaffold alone and no treatment. Sodium alginate hydrogel was used as the carrier for BMP-2 and bFGF and its features, including gelling, degradation and controlled release properties, was detected by the determination of gelation and degradation time coupled with a controlled release study of bovine serum albumin (BSA). AlamarBlue assay and alkaline phosphatase (ALP) activity were used to evaluate the proliferation and osteogenic differentiation of BMSCs in different groups. X-ray and histological examinations of the samples were performed after 4 and 12 weeks post-implantation to clarify new bone formation in the mandible defects. The results verified that the use of sodium alginate hydrogel as a controlled release carrier has good sustained release ability, and the combined application of bFGF and BMP-2 could significantly promote the proliferation and osteogenic differentiation of BMSCs (p < 0.05 or p < 0.01). In addition, X-ray and histological examinations of the samples exhibited that the dual release group had significantly higher bone formation than the other groups. The above results indicate that the delivery of both growth factors could enhance new bone formation and vascularization compared with delivery of BMP-2 or bFGF alone, and may supply a promising way of repairing large bone defects in bone tissue engineering.

Primary cancellous bone formation with BMP and micro-chambered beads: experimental study on sheep

PROBLEM

The physiological reconstruction of cancellous bone defects in surgery of the locomotor system is an unsatisfactorily solved problem.

AIMS

The aims of this study are to examine whether micro-chambered ß-tricalcium-phosphate (ß-TCP) beads provide a certain capillary force suctioning in blood and bone marrow thus forming a stable "negative"-replica of the bone marrow spaces. If so, a new approach for osteoconduction would yield primarily a scaffold of lamellar cancellous bone under load without a long-lasting remodeling process. Recombinant human bone morphogenetic protein (rhBMP) might even enhance all processes of defect healing, remodeling and ß-TCP resorption; gentamicin-loaded ε-caprolactone might protect the implant.

MATERIAL AND METHODS

Ten sheep were operated on; the patella-groove model and the tibial head were used. A defect of 9.4 × 20 mm was created using wet-grinding-diamond instruments. Micro-chambered ß-TCP-beads of 4-6 mm with 0.35 mg rhBMP-7 + 0.1 g collagen per animal, or 1.5 g demineralized bone matrix (DBM) paste on the contra-lateral side were implanted. Both osteoinduction groups were compared with the defect in the tibial heads where plain micro-chambered ceramic beads were inserted. Added to the beads was 12.5 mg gentamicin sulphate in 12.5 mg ε-caprolactone-carrier. Outward diffusion was prevented using a 1-mm-thick press-fit inserted ceramic lid. The bone healing, remodeling and resorption of the ceramic in a right-left comparison of the patella groove and the tibial head was examined at 6 weeks, 2 and 3 months; one animal in reserve was followed for 14 months. The animals were perfusion-fixed, the vasculature micro-casted with an acrylate and nondemineralized processed, and with μ-CT and microscopically documented.

RESULTS

A primary load-bearing spongiosa had developed around the beads, which shortened the remodeling process. The strong micro-chambered, resorbable ß-TCP-beads demonstrate high capillary strength, resorb blood and bone marrow, and represent a stable formative material which, as a carrier for the controlled local release of BMP, that accelerates bone healing, shortens resorption and remodeling compared with plain and DBM loaded implants.

CONCLUSION

Micro-chambered beads represent the bone-forming element, BMP yields a fast defect healing and enhanced remodeling of bone and resorption of ß-TCP compared to delayed and incomplete reconstruction and resorption of ß-TCP on the DBM-side, the plain implants reached nearly the same reconstruction, but far later compared with the BMP loaded implants.

Silica-chitosan hybrid coating on Ti for controlled release of growth factors

A hybrid material composed of a silica xerogel and chitosan was coated on Ti for the delivery of growth-factors. Fibroblast growth factor (FGF) and green fluorescence protein were incorporated into the coatings for hard tissue engineering. Silica was chosen as a coating material because of its high surface area as well as its good bioactivity. Chitosan provides mechanical stability and contributes to the control of the release rate of the growth factors. When the chitosan composition was 30% or more, the hybrid coating was stable physically and mechanically. The release of the growth-factors, observed in phosphate buffer solution at 37°C, was strongly dependent on the coating material. The hybrid coating containing FGF showed significantly improved osteoblast cell responses compared to the pure xerogel coating with FGF or the hybrid coating without FGF. These results indicate that the hybrid coating is potentially very useful in enhancing the bioactivity of metallic implants by delivering growth-factors in a controlled manner.

Zirconia-hydroxyapatite composite material with micro porous structure

OBJECTIVES

Titanium plates and apatite blocks are commonly used for restoring large osseous defects in dental and orthopedic surgery. However, several cases of allergies against titanium have been recently reported. Also, sintered apatite block does not possess sufficient mechanical strength. In this study, we attempted to fabricate a composite material that has mechanical properties similar to biocortical bone and high bioaffinity by compounding hydroxyapatite (HAp) with the base material zirconia (ZrO(2)), which possesses high mechanical properties and low toxicity toward living organisms.

METHODS

After mixing the raw material powders at several different ZrO(2)/HAp mixing ratios, the material was compressed in a metal mold (8 mm in diameter) at 5 MPa. Subsequently, it was sintered for 5 h at 1500°C to obtain the ZrO(2)/HAp composite. The mechanical property and biocompatibility of materials were investigated. Furthermore, osteoconductivity of materials was investigated by animal studies.

RESULTS

A composite material with a minute porous structure was successfully created using ZrO(2)/HAp powders, having different particle sizes, as the starting material. The material also showed high protein adsorption and a favorable cellular affinity. When the mixing ratio was ZrO(2)/HAp=70/30, the strength was equal to cortical bone. Furthermore, in vivo experiments confirmed its high osteoconductivity.

SIGNIFICANCE

The composite material had strength similar to biocortical bones with high cell and tissue affinities by compounding ZrO(2) and HAp. The ZrO(2)/HAp composite material having micro porous structure would be a promising bone restorative material.

Osteoclast and Osteoblast Activities on Carbonate Apatite Plates in Cell Cultures

Previous studies have demonstrated that carbonate apatite (CA) is superior to hydroxyapatite (HA) and β-tricalciumphosphate (β-TCP) with regard to osteoclastic resorption, but evidence on osteoclast and osteoblast response remains controversial. In the present study, the expression of bone related mRNA is examined on CA, HA, β-TCP, and titanium plates. ICR mouse osteoblast cells are cocultured with ICR mouse bone marrow cells. Crude osteoclast-like cell-rich suspensions are then seeded onto plates and cultured for 48 h. Total RNA is extracted and mRNA expression is examined by real-time RT-PCR. Amounts of vacuolar-type ATPase, cathepsin K, and TRAP mRNA are significantly greater on CA than on the other plates. The amount of osteoprotegerin mRNA is significantly greater on CA than on the other plates. RANKL mRNA expression, which is generally regarded as an osteoblast maker, varies with material, but shows no significant differences between CA and the other plates. The formation and activity of osteoclasts is greater with CA than with the other plates. Thus, CA is superior to β-TCP as a bioresorbable bone substitute for tissue engineering.

Ex vivo culturing of stromal cells with dexamethasone-loaded carboxymethylchitosan/poly(amidoamine) dendrimer nanoparticles promotes ectopic bone formation

Recently, our group has proposed a combinatorial strategy in tissue engineering principles employing carboxymethylchitosan/poly(amidoamine) dendrimer nanoparticles (CMCht/PAMAM) towards the intracellular release and regimented supply of dexamethasone (Dex) aimed at controlling stem cell osteogenic differentiation in the absence of typical osteogenic inducers, in vivo. In this work, we have investigated if the Dex-loaded CMCht/PAMAM dendrimer nanoparticles could play a crucial role in the regulation of osteogenesis, in vivo. Macroporous hydroxyapatite (HA) scaffolds were seeded with rat bone marrow stromal cells (RBMSCs), whose cells were expanded in MEM medium supplemented with 0.01 mg ml(-1) Dex-loaded CMCht/PAMAM dendrimer nanoparticles and implanted subcutaneously on the back of rats for 2 and 4 weeks. HA porous ceramics without RBMSCs and RBMSCs/HA scaffold constructs seeded with cells expanded in the presence and absence of 10(-8) M Dex were used as controls. The effect of initial cell number seeded in the HA scaffolds on the bone-forming ability of the constructs was also investigated. Qualitative and quantitative new bone formation was evaluated in a non-destructive manner using micro-computed tomography analyses of the explants. Haematoxylin and Eosin stained implant sections were also used for the histomorphometrical analysis. Toluidine blue staining was carried out to investigate the synthesis of proteoglycan extracellular matrix. In addition, alkaline phosphatase and osteocalcin levels in the explants were also quantified, since these markers denote osteogenic differentiation. At 4 weeks post-implantation results have shown that the novel Dex-loaded carboxymethylchitosan/poly(amidoamine) dendrimer nanoparticles may be beneficial as an intracellular nanocarrier, supplying Dex in a regimented manner and promoting superior ectopic de novo bone formation.

Regulation of the protein-loading capacity of hydroxyapatite by mercaptosuccinic acid modification

Loading and releasing protein in a controllable way is extremely important for the protein vehicles used in bone tissue engineering. To obtain a suitable carrier material for basic proteins, such as BMP or bFGF, hydroxyapatite particles containing mercaptosuccinic acid (mercaptosuccinic acid (Mer), (Mer-HAp)) were synthesized. Physicochemical evaluation of Mer-HAp suggested that Mer was contained in HAp particles: it either simply adsorbed onto HAp crystals or was trapped among the HAp crystals. A protein adsorption study using basic and acidic model proteins indicated that the synthesized Mer-HAp had selective loading properties of the basic protein. The loaded protein was gradually released from Mer-HAp in phosphate buffered saline. The protein release rate was different in each Mer-HAp synthesized with a different concentration of Mer. In addition, the protein release from Mer-HAp showed a similar profile with the Ca dissolution in different pH solutions, indicating that the Mer-HAp dissolution was concerned with the protein release from Mer-HAp. Thus, Mer-HAp is a useful candidate for the basic protein carrier because it has properties which enable the loading and releasing of protein in a controllable way.

Apatite Containing Aspartic Acid for Selective Protein Loading

Physico-chemical modifications of hydroxyapatite (HAp) materials are considered as pre-requisites for the development of new bioactive carrier materials for drug delivery and tissue engineering applications. Since acidic amino acids have well-documented affinities to both HAp and basic proteins, HAp modified by aspartic acid (Asp, acidic amino acid) might be one of the candidate substrates for a basic protein carrier. Here, we synthesized HAp in the presence of various concentrations of Asp and observed that HAp crystallinity and other physico-chemical properties were effectively modulated. Detailed studies indicated that Asp was not incorporated in the HAp crystal lattice, but rather was trapped in HAp crystals. Protein adsorption studies indicated that the HAp particles modified by Asp had a selective loading capacity for basic protein. Therefore, HAp particles containing Asp might have potential in drug delivery applications, especially as the carrier of basic proteins including bFGF and BMP.

Macroporous hydroxyapatite scaffolds for bone tissue engineering applications: physicochemical characterization and assessment of rat bone marrow stromal cell viability

In this work, a new methodology is reported for developing hydroxyapatite (HA) scaffolds using an organic sacrifice template. The novelty of work consists of possibility of obtaining porous and highly interconnected scaffolds mimicking the sacrificial component. Our purpose consisted of evaluating the physicochemical properties of the HA scaffolds by means of Fourier transform infra-red spectroscopy, X-ray diffraction analysis, and scanning electron microscopy (SEM) attached with an X-ray detector. The HA scaffolds obtained possess a porosity of approximately 70%, and macropores diameter in the range of 50-600 microm. In contrast, results regarding the microcomputed tomography analysis have demonstrated both high pore uniformity and interconnectivity across the scaffolds. The compressive strength of the HA scaffolds was found to be 30.2 +/- 6.0 MPa. Bioactivity of the HA scaffolds was assessed by immersion into a simulated body fluid solution, in vitro. SEM observations have showed a deposition of apatite on the surface of the HA scaffolds, with a "cauliflower-like" morphology after 1 day, and tend to be more pronounced with the immersion time. The changes in calcium and phosphorus concentration were monitored by inductively-coupled plasma optical emission spectrometry. Cytotoxicity of the HA scaffolds was preliminarily investigated by carrying direct observation of mouse fibroblasts cells (L929 cell-line) death in the inverted microscope, and then cell viability was determined by means of carrying out a MTS assay. Complementarily, a luminescent cell viability assay based on the quantification of adenosine triphosphate was performed using rat bone marrow stromal cells (RBMSCs). A LIVE/DEAD assay and SEM analysis allowed the visualization of the RBMSCs adhesion and proliferation on the surface of the HA scaffolds. According to the results obtained from 3D architecture, mechanical properties, biocompatibility, and adhesion tests, it is suggested that HA scaffolds has potential to find applications in bone tissue engineering scaffolding.

Composite chitosan/nano-hydroxyapatite scaffolds induce osteocalcin production by osteoblasts in vitro and support bone formation in vivo

There is a significant clinical need to develop alternatives to autografts and allografts for bone grafting procedures. Porous, biodegradable scaffolds based on the biopolymer chitosan have been investigated as bone graft substitutes, and the addition of calcium phosphate to these scaffolds has been shown to improve the mechanical properties of the scaffold and may increase osteoconductivity. In this study, in vitro mineralization was examined for osteoblasts seeded in a porous scaffold composed of fused chitosan/nano-hydroxyapatite microspheres. Human fetal osteoblasts were cultured on composite and chitosan scaffolds for 21 days. On days 1, 4, 7, 14, and 21, total dsDNA, alkaline phosphatase, type I collagen, and osteocalcin production were measured. Total cellularity (measured by dsDNA), alkaline phosphatase, and type I collagen production were similar between the two scaffold groups. However, osteocalcin production occurred significantly earlier (day 7 vs. day 21) and was more than three times greater (0.0022 vs. 0.0068 ng/mL/ng DNA) on day 21 when osteoblasts were cultured on composite scaffolds. Osteocalcin is a marker of late osteoblastic differentiation and mineralized bone matrix formation. Therefore, the increase in osteocalcin production seen when cells were cultured on composite scaffolds may indicate that these scaffolds were superior to chitosan-only scaffolds in facilitating osteoblast mineralization. Composite scaffolds were also shown to be biocompatible and osteoconductive in a preliminary critical size rat calvarial defect study. These results demonstrate the potential of composite chitosan/nano-hydroxyapatite scaffolds to be used in bone tissue engineering.

Enhancement of bone formation in hydroxyapatite implants by rhBMP-2 coating

The combination of hydroxyapatite (HA) implants serving as osteoconductive scaffold with growth factors is an interesting approach for the improvement of bone defect healing. The purpose of this study was to test whether recombinant human bone morphogenetic protein-2 (rhBMP-2) coating of solid HA-implants improves bone formation in a cortical bone defect. Cylindrical trephine mill defects (diameter: 9.8 mm, depth: 10 mm) were created into the cortical tibia shaft of minipigs and subsequently filled either by plain HA cylinders (Endobon) or by rhBMP-2-coated HA cylinders. Fluorochrome labeling for the evaluation of time-dependent bone formation was done on days 8, 9, and 10 postsurgery with tetracyclin-100, at days 25 and 30 with alizarin-komplexon, and finally on days 32, 37, 73, and 79 with calcein green. Twelve weeks after implantation, the tibiae were harvested and were prepared for standard histological staining, fluorochrome analysis, and histomorphometry. Coating of HA implants with rhBMP-2 led to significant enhanced new bone formation of 84.7% (+/-4.6%) of the implant area with almost complete bony incorporation compared with only 27.7% (+/-8.5%) in the uncoated HA implants (p = 0.028). In both types of implants, osteoconduction of HA led to bone ingrowth of the surrounding host bone into the implants. However, only rhBMP-2-coated implants showed multitopic de novo bone formation reflecting the osteoinductive properties of rhBMP-2 in all areas of the HA implant. This study showed that the coating of HA ceramic implants with rhBMP-2 can significantly enhance new bone formation attributable to its osteoinductive effects.

The efficacy of Biobon and Ostim within metaphyseal defects using the Göttinger Minipig

INTRODUCTION

To compare bio, osteocompatibility, rate of resorption and remodeling dynamics of two clinically used bone substitutes.

MATERIALS AND METHODS

In a randomized fashion Biobon and Ostim were implanted bilaterally into the proximal metaphyseal tibiae of 18 Göttinger Minipigs in a direct right versus left "intra-individual" comparison. Fluorescent labelling was used. Microradiographic, histological and morphometric evaluation was carried out at 6, 12 and 52 weeks.

RESULTS

Both bone substitutes showed good biocompatibility, bioactivity and osteoconductivity. The degradation dynamics of both materials differed. Degradation of Ostim stopped after 6 weeks postoperatively, whereas Biobon was degraded slowly but evenly over the time intervals. Only at 6 weeks a significant (P < 0.05) difference in resorption rate was detected. Both Biobon and Ostim showed incomplete resorption after a year.

CONCLUSION

After 1 year no "restitutio ad integrum" could be observed in either group. Similar to ceramics, a thorough osseous incorporation seemed to inhibit further degradation of both bone substitute materials.

Effect of combined application of bFGF and inorganic polyphosphate on bioactivities of osteoblasts and initial bone regeneration

Basic fibroblast growth factor (bFGF) and inorganic polyphosphate (poly(P)) have been recognized as therapeutic agents that enhance bone regeneration. It has also been shown that poly(P) may enhance the mitogenic activity of bFGF. The purpose of this study is to evaluate the combined effect of bFGF and poly(P) on bioactivities of osteoblasts and initial bone regeneration in vitro and in vivo. MC3T3-E1 cells were treated with bFGF, poly(P) or bFGF+poly(P), then subjected to cell proliferation assay, alkaline phosphatase (ALP) activity measurement, quantitative real-time reverse transcription-polymerase chain reaction and Alizarin S Red staining. In an in vivo study, bFGF-, poly(P)- and bFGF+poly(P)-modified interconnected porous hydroxyapatite (IPHA) complexes were fabricated, and placed into the femurs of rabbits to evaluate new bone formation histologically and histomorphometrically. The highest enhancement of cell proliferation were observed in those treated with bFGF+poly(P) on days 5 and 7. Cells treated with bFGF+poly(P) also exhibited increased ALP activity on days 5 and 10, up-regulated mRNA levels of osteocalcin and osteopontin, and enhanced calcification when compared to the non-treated cells. In vivo, the highest bone formation ratio was observed in bFGF+poly(P)-modified IPHA complexes. This study indicated that co-application of bFGF and poly(P) may provide enhanced bone formation by modulating cell proliferation and the mineralization process. It is anticipated that a combined application of bFGF and poly(P) can provide a novel method for bone regeneration in clinical use.

Basic fibroblast growth factor suspended in Matrigel improves titanium implant fixation in ovariectomized rats

Basic fibroblast growth factor (bFGF) has high potential for tissue regeneration; however, its in vivo effects are unpredictable due to the short-term survival. This study sought to evaluate the effects of bFGF suspended in Matrigel on the implant fixation in ovariectomized (OVX) rats. In vitro, the release kinetics of bFGF was tested using an immuno-ligand-assay. In vivo, eighty titanium implants were randomly divided into 4 groups and inserted in the tibiae of forty OVX rats: no treatment group, bFGF alone group, Matrigel alone group and bFGF+Matrigel group. At 3 months after implantation, tibiae were examined by histology, micro-CT and push-out test. We found that Matrigel could prolong the life span of bFGF in vitro with a sustained release during the 21 days. In vivo, bFGF or Matrigel alone had little effect on the fixation of implant in OVX rats, but bFGF suspended in Matrigel induced nearly 2-fold of peri-implant new bone formation and 4-fold of implant mechanical stability when compared to other 3 groups. The results of this study suggest that Matrigel could be used as a carrier of bFGF and prolonged its release around implant, which may improve implant fixation, especially in site of post-menopausal osteoporosis.

Promotion of bone regeneration by CCN2 incorporated into gelatin hydrogel

CCN family protein 2/connective tissue growth factor (CCN2/CTGF) is a unique molecule that promotes the entire endochondral ossification process and regeneration of damaged articular cartilage. Also, CCN2 has been shown to enhance the adhesion and migration of bone marrow stromal cells as well as the growth and differentiation of osteoblasts; hence, its utility in bone regeneration has been suggested. Here, we evaluated the effect of CCN2 on the regeneration of an intractable bone defect in a rat model. First, we prepared two recombinant CCN2s of different origins, and the one showing the stronger effect on osteoblasts in vitro was selected for further evaluation, based on the result of an in vitro bioassay. Next, to obtain a sustained effect, the recombinant CCN2 was incorporated into gelatin hydrogel that enabled the gradual release of the factor. Evaluation in vivo indicated that CCN2 continued to be released at least for up to 14 days after its incorporation. Application of the gelatin hydrogel-CCN2 complex, together with a collagen scaffold to the bone defect prepared in a rat femur resulted in remarkable induction of osteoblastic mineralization markers within 2 weeks. Finally, distinct enhancement of bone regeneration was observed 3 weeks after the application of the complex. These results confirm the utility of CCN2 in the regeneration of intractable bone defects in vivo when the factor is incorporated into gelatin hydrogel.

Effect of combined local treatment with zoledronic acid and basic fibroblast growth factor on implant fixation in ovariectomized rats

Osteoporosis is a skeletal disorder characterized by low bone mass and deterioration of bone microarchitecture resulting in bone fragility, which impairs fixation of the implants. Zoledronic acid (ZOL) is a potential inhibitor of osteoclast-mediated bone resorption and basic fibroblast growth factor (bFGF) is a growth factor that stimulates osteoblast-mediated bone formation, and these drugs could enhance fixation of implants under osteoporotic conditions. In this study, 40 ovariectomized (OVX) rats were randomly divided into 4 groups (n=10 for each group) and underwent bilateral tibiae implantation using hydroxyapatite (HA)-coated titanium implant: Control group (distilled water immersing before implantation), ZOL group (1 mg/ml of ZOL immersing), bFGF group (20 microg/ml of bFGF immersing), and ZOL+bFGF group (1 mg/ml of ZOL and 20 microg/ml of bFGF immersing). At 3 months after implantation, all animal were sacrificed and the tibiae were harvested for histology, micro-CT examinations and biomechanical testing. Bone area and contact, determined by histomorphometric analysis, were 2.7-fold and 1.8-fold in the ZOL-treated implants, 1.9-fold and 1.8-fold in the bFGF-treated implants, 3.6-fold and 2.3-fold in the both-treated implants compared with controls (p<0.01). Such significant effects were further confirmed by microstructure parameters, the bone volume ratio and the percentage osteointegration were significantly increased by ZOL treatment (3.0-fold and 1.8-fold), bFGF treatment (1.2-fold and 1.9-fold) and ZOL+bFGF treatment (3.3-fold and 2.7-fold) (p<0.001). In addition, push-out test showed that the maximum force and the corresponding interfacial shear strength of the implants treated by ZOL, bFGF and ZOL+bFGF was 8.4-fold and 8.6-fold, 3.8-fold and 3.7-fold, 10.8-fold and 10.7-fold of the control levels, respectively (p<0.05). The combined treatment was better than either treatment alone for force, but was not different from ZOL alone for interfacial strength. The significant correlation between biomechanical and micro-CT parameters demonstrates the role of microstructure assessments in predicting mechanical fixation of implants (p<0.01). Our study suggests that locally applied ZOL or bFGF may improve implant fixation in the ovariectomized rats, and that combined treatment has more beneficial effects on osseointegration, peri-implant bone formation and maximum force than either intervention alone.

The minipig model for experimental chondral and osteochondral defect repair in tissue engineering: retrospective analysis of 180 defects

Articular cartilage repair is still a challenge in orthopaedic surgery. Although many treatment options have been developed in the last decade, true regeneration of hyaline articular cartilage is yet to be accomplished. In vitro experiments are useful for evaluating cell-matrix interactions under controlled parameters. When introducing new treatment options into clinical routine, adequate animal models are capable of closing the gap between in vitro experiments and the clinical use in human beings. We developed an animal model in the Göttingen minipig (GMP) to evaluate the healing of osteochondral or full-thickness cartilage defects. The defects were located in the middle third of the medial portion of the patellofemoral joint at both distal femurs. Chondral defects were 6.3 mm, osteochondral defects either 5.4 or 6.3 mm in diameter and 8 or 10 mm deep. In both defects the endogenous repair response showed incomplete repair tissue formation up to 12 months postoperatively. Based on its limited capability for endogenous repair of chondral and osteochondral defects, the GMP is a useful model for critical assessment of new treatment strategies in articular cartilage tissue engineering.

A bFGF/TCP-composite inhibits bone formation in a sheep model

Basic fibroblast growth factor is a well known osteostimulative protein. The effects of basic fibroblast growth factor are dose-dependent and, when used with a carrier, influenced by the release kinetics. Aim of our study was to determine the effects of a composite of basic fibroblast growth factor and a newly developed, in situ setting tricalcium phosphate (TCP) cement. A trepanation defect in the distal femoral epiphysis of Merino-Mix sheep with a diameter of 9.4 mm and 10 mm depth was filled with the in situ setting TCP cement combined with 0 or 200 microg of bFGF/cm(3) TCP, autologous bone graft or left empty. The sheep were euthanized after 3 months. The defect and the periimplant area were examined by microradiography, histology, and histomorphometry. The data was analyzed with the help of the Wilcoxon and Kruskal-Wallis tests. Defects filled with TCP with or without bFGF showed a close bone-cement contact. The histomorphometric analysis revealed that the addition of bFGF inhibited the ingrowth of bone significantly, while the resorption of the cement was not influenced. In conclusion, the clinical application of this bFGF/TCP-composite does not seem promising. The reason for the inhibition of new bone formation will be discussed, but requires further investigation.

Promotion of Hydroxyapatite-Associated, Stem Cell-Based Bone Regeneration by CCN2

Multiple roles have been already recognized for CCN2 in cartilage development and regeneration. However, the effects of CCN2 on bone regeneration remain to be elucidated. In this study, the utility of CCN2 on bone regeneration was examined in vitro and in vivo in combination with hydroxyapatite (HAp) as a scaffold. Human bone marrow stromal cells (hBMSCs) were isolated from human iliac bone marrow aspirates of healthy donors and expanded, and the effects of CCN2 on their proliferation and migration were examined in vitro. The proliferation of hBMSCs on a plastic or HAp plate was significantly enhanced by CCN2. Moreover, the migration of hBMSCs also dramatically increased by CCN2. Interestingly, a C-terminal signal modular fragment of CCN2 (CT-module) also enhanced the cell proliferation and migration as efficiently as the full-length CCN2. Next, in order to estimate the effect of CCN2 on the migration and survival of hBMSCs and bone formation inside the HAp scaffold in vivo, two experiments were performed. First, the porous HAp carrier was cultured with hBMSCs for a week, and the cell–scaffold hybrid was transplanted with or without CCN2 subcutaneously into immunocompromised mice. CCN2 accelerated the hBMSC-like cell migration and survival inside the porous HAp within 4 weeks after transplantation. Second, the porous HAp carrier with or without CCN2 was directly implanted into bone defects within a rabbit mandible, and bone regeneration inside was evaluated. As a result, CCN2 efficiently induced the cell invasion and bone formation inside the porous HAp scaffold. These findings suggest that CCN2 and its CT-module fragment could be useful for regeneration and reconstruction of large-scale bone defects.

Osseointegration in arthroplasty: can simvastatin promote bone response to implants?

Cementless fixation depends on bone ingrowth for long-term success. Simvastatin as a lipid lowering agent has been demonstrated to have osteoanabolic effects. This study was designed to measure the possible effect of simvastatin on implant osseointegration. Bilateral femoral implantation of titanium cylinders was performed in 20 rabbits. Blood lipid levels were measured pre- and postoperatively. Scanning electron microscopy (SEM) was used to measure the percentage of the surface of each implant in contact with bone and mechanical pull-out testing was performed. The blood lipid levels were significantly reduced in the simvastatin group. Histomorphometric examination revealed increased bone ingrowth and mechanical examination showed increased interface strength in the simvastatin group. Mechanical and histological data showed superior stability and osseous adaptation at the bone/implant interface for the simvastatin group. We conclude that simvastatin has potential as a means of enhancing bone ingrowth, which is a key factor in the longevity of cementless implants.

Connexin 43 expression of foreign body giant cells after implantation of nanoparticulate hydroxyapatite

In bone a role of connexin 43 has been implicated with the fusion of mononuclear precursors of the monocyte/macrophage lineage into multinucleated cells. In order to investigate the putative role of connexin 43 in formation of bone osteoclast-like foreign body giant cells which are formed in response to implantation of biomaterials, nanoparticulate hydroxyapatite had been implanted into defects of minipig femura. After 20 days the defect areas were harvested and connexin 43 expression and synthesis were investigated by using immunohistochemistry, Western Blot, and in situ hybridization within macrophages and osteoclast-like foreign body giant cells. Morphological analysis of gap junctions is performed ultrastructurally. As shown on protein and mRNA level numerous connexin 43 positive macrophages and foreign body giant cells (FBGC) were localized within the granulation tissue and along the surfaces of the implanted hydroxyapatite (HA). Besides, the formation of FBGC by fusion of macrophages could be shown ultrastructurally. Connexin 43 labeling observed on the protein and mRNA level could be attributed to gap junctions identified ultrastructurally between macrophages, between FBGC, and between FBGC and macrophages. Annular gap junctions in the cytoplasm of FBGC pointed to degradation of the channels, and the ubiquination that had occurred in the course of degradation was confirmed by Western blot analysis. All in all, the presently observed pattern of connexin 43 labeling refers to an functional role of gap junctional communication in the formation of osteoclast-like foreign body giant cells formed in response to implantation of the nanoparticulate HA.

Characterization of selective laser-sintered hydroxyapatite-based biocomposite structures for bone replacement

Integration of the bone into the implant is highly desirable for the long-term performance of the implant. The development of a bone–implant interface is influenced by the surface morphology and roughness, surface wettability and porosity of the implants. This study characterizes these important properties of a hydroxyapatite-based biocomposite structure fabricated by selective laser sintering (SLS) with a comparison to a moulded specimen. The sintered specimens exhibited a rougher surface with open surface pores and a highly interconnected internal porous structure. It was shown that the characteristics of the powder particles used in the SLS provided a more influential means to modify the surface morphology and the features of the internal pores than laser parameter variation. The correlation of wettability and porous structure shows that although surface open pores could help cell ingrowth and bone regeneration, they resulted in a poorer wettability of the materials, which may not encourage initial cell attachment and adhesion. The potential solution to improve the wettability and cell anchorage is discussed.

Promotion of attachment of human bone marrow stromal cells by CCN2

Cell attachment is a crucial step in tissue regeneration. In this study, human bone marrow stromal cells (hBMSCs) were isolated, and the effects of CCN2 on their attachment were examined. CCN2 significantly enhanced the hBMSC attachment, and this enhanced cell attachment was mainly regulated by the C-terminal module of CCN2. This enhancement was negated by the anti-integrin alpha(v)beta(3) antibody and p38 MAPK inhibitor, and phosphorylation of p38 MAPK was detected upon the enhanced cell attachment mediated by CCN2. We thus conclude that CCN2 enhances hBMSC attachment via integrin-p38 MAPK signal pathway. Enhanced hBMSC attachment on hydroxyapatite plates by CCN2 further indicated the utility of CCN2 in bone regeneration.

Glycerol-l-lactide coating polymer leads to delay in bone ingrowth in hydroxyapatite implants

Glycerol-l-lactide as coating polymer for the delivery of basic fibroblast growth factor (bFGF) from hydroxyapatite (HA) ceramic implants was shown to lead to significant delay in bone ingrowth into the implants compared to implants without the coating polymer. The purpose of this work was to study bone ingrowth in HA ceramic implants with and without the coating polymer but without growth factors to enable differentiation between a locking effect of the pores by the polymer and the fact of inactivation of the growth factors by the polymer, which could both be possible for the delay. A defect was created in the subchondral region of both femurs in 24 miniature-pigs and was either filled by the HA implants with or without the coating polymer. Histomorphometry showed a significant delay in bone ingrowth in the polymer coated implants both after 6 and 12 weeks. Detailed histology revealed that the HA pores were completely "locked" by the polymer leading to complete loss of the osteoconductive properties of the HA. Also electron microscopy showed filling of the HA pores by the polymer. Therefore, it can be concluded that glycerol-l-lactide should not be used to coat HA ceramic implants due to significant delay in bone ingrowth.

Bohrmehl: Eine Quelle vitaler Zellen!

Reaming debris is generated in the course of intramedullary reaming of long bones. Up to now there has been little information about the composition of reaming debris. Especially, it remains to be elucidated if reaming debris contains vital cells. The goal of the present vitro investigation has been the harvest of cells from human reaming debris and the subsequent characterization of the cells. 21 specimens of human reaming debris have been investigated. Each specimen has been divided into two parts. One part has been examined by means of transmission electron microscopy while the other part of each specimen has been transferred into culture dishes. The developing cell cultures were characterized by using FACS analysis and were incubated within osteogenic, adipogenic and chondrogenic differentiation media. The results of electron microscopy have revealed the presence of both, vital cells and massively altered cells. Cell growth occurred after initial plating of all specimens. The cells which were grown within the culture dishes could be characterized as mesenchymal stem cells on the basis of their morphology, differentiation capacity and antigen profile. Based upon these results reaming debris has to be regarded as a source of vital mesenchymal stem cells. It remains to be elucidated, if reaming debris can be used as an alternative to bone tissue grafting.

Blood vessel formation after soft-tissue implantation of hyaluronan-based hydrogel supplemented with copper ions

The possibility of ameliorating bone healing of implanted bone allografts is a field of great interest. Early vascular invasion is a key factor in bone allograft incorporation. It is well known that copper ions (Cu2+) show a proangiogenic action favouring the development of new vessels. In this work a hyaluronan based 50% hydrogel (Hyal-50%) was enriched with (Cu2+) and its proangiogenic activity was evaluated. Fifteen Sprague Dawley female rats were submitted to the subcutaneous implantation of Hyal-50%, freeze-dried bone allografts, Hyal-50%-Cu2+, freeze-dried bone allografts plus Hyal-50% and freeze-dried bone allografts plus Hyal-50%-Cu2+. One month later, histomorphometric analysis evidenced the presence of a fibrous-reactive capsule around all specimens showing significant differences among groups (p<0.0005). The highest thickness of the fibrous capsule was found around the freeze-dried bone implants (p<0.05); as well as the Hyal-50%-Cu2+ plus freeze-dried bone (15.2%, p<0.05) and Hyal 50% plus freeze-dried bone (21.4%, p<0.0005) implants showed a significant higher thickness compared with Hyal 50% and Hyal-50%-Cu2+. Statistical analysis showed a significant (p<0.01) higher vascular density in Hyal- 50%-Cu2+ and Hyal-50%-Cu2+ plus freeze-dried bone group when compared to other groups. The present preliminary results suggest the advantages offered by the combined use of a well-known biocompatible and tissue healing promoting material (Hyal-50%) and a new technique that consists of stimulating tissue vascularization using Cu2+ and that bone allograft incorporation may benefit from this technology.

Synthesis of hydroxyapatite crystals using amino acid-capped gold nanoparticles as a scaffold

Inorganic composites are of special interest for biomedical applications such as in dental and bone implants wherein the ability to modulate the morphology and size of the inorganic crystals is important. One interesting possibility to control the size of inorganic crystals is to grow them on nanoparticles. We report here the use of surface-modified gold nanoparticles as templates for the growth of hydroxyapatite crystals. Crystal growth is promoted by a monolayer of aspartic acid bound to the surface of the gold nanoparticles; the carboxylate ions in aspartic acid are excellent binging sites for Ca(2+) ions. Isothermal titration calorimetry studies of Ca(2+) ion binding with aspartic acid-capped gold nanoparticles indicates that the process is entropically driven and that screening of the negative charge by the metal ions leads to their aggregation. The aggregates of gold nanoparticles are believed to be responsible for assembly of the platelike hydroxyapatite crystals into quasi-spherical superstructures. Control experiments using uncapped gold nanoparticles and pure aspartic acid indicate that the amino acid bound to the nanogold surface plays a key role in inducing and directing hydroxyapatite crystal growth.

Effect of glycerol-l-lactide coating polymer on bone ingrowth of bFGF-coated hydroxyapatite implants

Basic fibroblast growth factor (bFGF)-coated hydroxyapatite (HA) cylinders showed good bony incorporation in a previously conducted animal study. However, some cylinders exhibited focal inhomogeneous bone ingrowth. The purpose of the current study was to test whether glycerol-L-lactide polymer coating could improve release properties and bone incorporation of bFGF-coated HA implants. bFGF-coated HA cylinders with or without coating polymer were investigated for in vitro release of bFGF by an immuno-ligand-assay and also for bone ingrowth in miniature pigs after 42 and 84 days. Release from bFGF polymer composites was lower for the first 3 days compared to the other group but was more homogenous and detectable amounts were still found after 20 days. There was significant delay in bone ingrowth of the polymer implants in which even after 84 days bone ingrowth was not completed, whereas in the other group incorporation after 42 days occurred. Detailed histology revealed filling of the HA pores with the polymer, making ingrowth of the surrounding host bone impossible. Only after 84 days starting resorption of the polymer accompanied by bone ingrowth was found. The current study showed that glycerol-L-lactide is not suitable for coating of HA implants due to polymer induced "locking" of HA pores.

A novel method to produce hydroxyapatite objects with interconnecting porosity that avoids sintering

Porous objects of carbonated apatite were prepared by mixing polyvinyl alcohol fibres (PVA) and sodium chloride as porogens with nanocrystalline carbonated apatite powder. After cold isostatic pressing (CIP) and dissolving the porogens, the bioceramic showed an interconnecting porosity with pore diameters in the range of 250-400 microm. The method can be transposed to any material that is insoluble in water (like many polymers). Such objects are promising for bone regeneration because the interconnecting porosity in carbonated apatite provides a good environment for bone attachment and ingrowth.