1
|
Gavazzoni A, Filho LI, Hernandes L. Analysis of bone formation and membrane resorption in guided bone regeneration using deproteinized bovine bone mineral versus calcium sulfate. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:167. [PMID: 30392111 DOI: 10.1007/s10856-018-6167-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 10/11/2018] [Indexed: 06/08/2023]
Abstract
Guided Bone Regeneration (GBR) is a technique based on the use of a physical barrier that isolates the region of bone regeneration from adjacent tissues. The objective of this study was to compare GBR, adopting a critical-size defect model in rat calvaria and using collagen membrane separately combined with two filling materials, each having different resorption rates. A circular defect 8 mm in diameter was made in the calvaria of Wistar rats. The defects were then filled with calcium sulfate (CaS group) or deproteinized bovine bone mineral (DBBM group) and covered by resorbable collagen membrane. The animals were killed 15, 30, 45 and 60 days after the surgical procedure. Samples were collected, fixed in 4% paraformaldehyde and processed for paraffin embedding. The resultant sections were stained with H&E for histological and histomorphometric study. For the histomorphometric study, the area of membrane was quantified along with the amount of bone formed in the region of the membrane. Calcium sulfate was reabsorbed more rapidly compared to DBBM. The CaS group had the highest percentages of remaining membrane at 15, 30, 45 and 60 days, compared to the DBBM group. The DBBM group had the highest amount of new bone at 45 and 60 days compared to the CaS group. Based on these results, it was concluded that the type of filling material may influence both the resorption of collagen membrane and amount of bone formed.
Collapse
Affiliation(s)
| | - Liogi Iwaki Filho
- Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil
| | - Luzmarina Hernandes
- Department of Morphological Sciences, State University of Maringá, Maringá, Paraná, Brazil.
| |
Collapse
|
2
|
Pförringer D, Harrasser N, Mühlhofer H, Kiokekli M, Stemberger A, van Griensven M, Lucke M, Burgkart R, Obermeier A. Osteoinduction and -conduction through absorbable bone substitute materials based on calcium sulfate: in vivo biological behavior in a rabbit model. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:17. [PMID: 29318379 DOI: 10.1007/s10856-017-6017-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 12/05/2017] [Indexed: 06/07/2023]
Abstract
Calcium sulfate (CS) can be used as an antibiotically impregnated bone substitute in a variety of clinical constellations. Antibiotically loaded bone substitutes find specific application in orthopedic and trauma surgery to prevent or treat bone infections especially in relation to open bone defects. However, its use as a structural bone graft reveals some concerns due to its fast biodegradation. The addition of calcium carbonate and tripalmitin makes CS formulations more resistant to resorption leaving bone time to form during a prolonged degradation process. The aim of the present study was the evaluation of biocompatibility and degradation properties of newly formulated antibiotically impregnated CS preparations. Three different types of CS bone substitute beads were implanted into the tibial metaphysis of rabbits (CS dihydrate with tripalmitin, containing gentamicin (Group A) or vancomycin (Group B); Group C: tobramycin-loaded CS hemihydrate). Examinations were performed by means of x-ray, micro-computed tomography (micro-CT) and histology after 4, 6, 8 and 12 weeks. Regarding biocompatibility of the formulations, no adverse reactions were observed. Histology showed formation of vital bone cells attached directly to the implanted materials, while no cytotoxic effect in the surrounding of the beads was detected. All CS preparations showed osteogenesis associated to implanted material. Osteoblasts attached directly to the implant surface and revealed osteoid production, osteocytes were found in newly mineralized bone. Group C implants (Osteoset®) were subject to quick degradation within 4 weeks, after 6-8 weeks there were only minor remnants with little osteogenesis demonstrated by histological investigations. Group A implants (Herafill®-G) revealed similar degradation within atleast 12 weeks. In contrast, group B implants (CaSO4-V) were still detectable after 12 weeks with the presence of implant-associated osteogenesis atlatest follow-up. In all of these preparations, giant cells were found during implant degradation on surface and inside of resorption lacunae. None of the analyzed CS preparations triggered contact activation. All implants demonstrated excellent biocompatibility, with implants of Group A and B showing excellent features as osteoconductive and -inductive scaffolds able to improve mechanical stability.
Collapse
Affiliation(s)
- D Pförringer
- Klinikum rechts der Isar der Technischen Universität München, Klinik und Poliklinik für Unfallchirurgie, München, Germany.
| | - N Harrasser
- Klinikum rechts der Isar der Technischen Universität München, Klinik für Orthopädie und Sportorthopädie, München, Germany
| | - H Mühlhofer
- Klinikum rechts der Isar der Technischen Universität München, Klinik für Orthopädie und Sportorthopädie, München, Germany
| | - M Kiokekli
- Klinikum rechts der Isar der Technischen Universität München, Klinik für Orthopädie und Sportorthopädie, München, Germany
| | - A Stemberger
- Klinikum rechts der Isar der Technischen Universität München, Klinik für Orthopädie und Sportorthopädie, München, Germany
| | - M van Griensven
- Klinikum rechts der Isar der Technischen Universität München, Klinik und Poliklinik für Unfallchirurgie, München, Germany
| | - M Lucke
- Chirurgisches Klinikum München Süd, München, Germany
| | - R Burgkart
- Klinikum rechts der Isar der Technischen Universität München, Klinik für Orthopädie und Sportorthopädie, München, Germany
| | - A Obermeier
- Klinikum rechts der Isar der Technischen Universität München, Klinik für Orthopädie und Sportorthopädie, München, Germany
| |
Collapse
|
3
|
SEM-EDX Study of the Degradation Process of Two Xenograft Materials Used in Sinus Lift Procedures. MATERIALS 2017; 10:ma10050542. [PMID: 28772900 PMCID: PMC5459008 DOI: 10.3390/ma10050542] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 03/24/2017] [Accepted: 05/11/2017] [Indexed: 12/13/2022]
Abstract
Some studies have demonstrated that in vivo degradation processes are influenced by the material’s physico-chemical properties. The present study compares two hydroxyapatites manufactured on an industrial scale, deproteinized at low and high temperatures, and how physico-chemical properties can influence the mineral degradation process of material performance in bone biopsies retrieved six months after maxillary sinus augmentation. Residual biomaterial particles were examined by field scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX) to determine the composition and degree of degradation of the bone graft substitute material. According to the EDX analysis, the Ca/P ratio significantly lowered in the residual biomaterial (1.08 ± 0.32) compared to the initial composition (2.22 ± 0.08) for the low-temperature sintered group, which also presented high porosity, low crystallinity, low density, a large surface area, poor stability, and a high resorption rate compared to the high-temperature sintered material. This demonstrates that variations in the physico-chemical properties of bone substitute material clearly influence the degradation process. Further studies are needed to determine whether the resorption of deproteinized bone particles proceeds slowly enough to allow sufficient time for bone maturation to occur.
Collapse
|
4
|
RETRACTED: Scanning electron microscopy study of new bone formation following small and large defects preserved with xenografts supplemented with pamidronate—A pilot study in Fox-Hound dogs at 4 and 8 weeks. Ann Anat 2017; 209:61-68. [DOI: 10.1016/j.aanat.2016.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 08/24/2016] [Accepted: 09/19/2016] [Indexed: 11/24/2022]
|
5
|
Cha JK, Lim HC, Lee JS, Choi SH, Woo KM, Jung UW. Sinus augmentation using a histone deacetylase inhibitor in a calcium sulfate carrier in rabbit: A pilot study. J Biomed Mater Res B Appl Biomater 2016; 105:1916-1923. [DOI: 10.1002/jbm.b.33727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 05/13/2016] [Accepted: 05/24/2016] [Indexed: 01/15/2023]
Affiliation(s)
- Jae Kook Cha
- Department of Periodontology; Research Institute for Periodontal Regeneration, Yonsei University, College of Dentistry; Seoul Republic of Korea
| | - Hyun-Chang Lim
- Department of Periodontology; School of Dentistry; Kyung Hee University; Seoul Republic of Korea
| | - Jung-Seok Lee
- Department of Periodontology; Research Institute for Periodontal Regeneration, Yonsei University, College of Dentistry; Seoul Republic of Korea
| | - Seong-Ho Choi
- Department of Periodontology; Research Institute for Periodontal Regeneration, Yonsei University, College of Dentistry; Seoul Republic of Korea
| | - Kyung Mi Woo
- Department of Pharmacology and Dental Therapeutics; School of Dentistry; Seoul National University; Seoul Republic of Korea
| | - Ui-Won Jung
- Department of Periodontology; Research Institute for Periodontal Regeneration, Yonsei University, College of Dentistry; Seoul Republic of Korea
| |
Collapse
|
6
|
Wang JS, Tägil M, Isaksson H, Boström M, Lidgren L. Tissue reaction and material biodegradation of a calcium sulfate/apatite biphasic bone substitute in rat muscle. J Orthop Translat 2015; 6:10-17. [PMID: 30035078 PMCID: PMC5987024 DOI: 10.1016/j.jot.2015.11.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 11/04/2015] [Accepted: 11/23/2015] [Indexed: 12/15/2022] Open
Abstract
Background/Objective A biphasic ceramic bone substitute consisting of calcium sulfate and hydroxyapatite has been reported to give good clinical outcome regarding bone regeneration and may serve as a carrier for antibiotics in the treatment of bone infections. Often, the overlying muscle is in direct contact with the synthetic graft. The dissolving bone substitute induces inflammation, which may be harmful to the surrounding soft and muscle tissue. The aim of the present study was to evaluate the surrounding soft tissue reaction and the biodegradation of the biphasic bone substitute. Methods Rods (3 mm × 6 mm) were cast and implanted in the rat abdominal rectus muscle. The rods were either soaked or not soaked in autologous bone marrow before insertion to induce bone formation. Thirty-two rats underwent bilateral operation. After 6 weeks and 12 weeks, the bone substitute material and the surrounding muscle were harvested. The right rod was evaluated by histology to study tissue reaction and the left rod was analysed with micro-computed tomography and scanning electron microscopy to study bone substitute degradation. Results The muscle tissue around the material was similar at 6 weeks and 12 weeks, with or without prior treatment with bone marrow. The remaining material showed close contact with the muscle, and blood vessels penetrated the material in both groups. Wide bundles of collagen were embedded around the apatite particles, more at the 12-week time point. No bone formation was found, either at 6 weeks or 12 weeks, and scanning electron microscopy showed that the calcium sulfate phase was resorbed after 6 weeks with the calcium phosphate phase remaining intact. Micro-computed tomography showed significantly more hydroxyapatite at 6 weeks than after 12 weeks. Conclusion Calcium sulfate hydroxyapatite bone substitute can be used as a carrier for antibiotics or other drugs, without adverse reaction due to the fast resorption of the calcium sulfate. No bone formation was seen despite treating the bone substitute with autologous bone marrow.
Collapse
Affiliation(s)
- Jian-Sheng Wang
- Department of Orthopaedics, Clinical Sciences, Lund University, Lund, Sweden
| | - Magnus Tägil
- Department of Orthopaedics, Clinical Sciences, Lund University, Lund, Sweden
| | - Hanna Isaksson
- Department of Orthopaedics, Clinical Sciences, Lund University, Lund, Sweden.,Department of Biomedical Engineering, Lund University, Lund, Sweden.,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | | | - Lars Lidgren
- Department of Orthopaedics, Clinical Sciences, Lund University, Lund, Sweden
| |
Collapse
|
7
|
Goh YF, Akram M, Alshemary AZ, Hussain R. Synthesis, characterization and in vitro study of magnetic biphasic calcium sulfate-bioactive glass. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 53:29-35. [DOI: 10.1016/j.msec.2015.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 03/18/2015] [Accepted: 04/10/2015] [Indexed: 10/23/2022]
|
8
|
Ramírez-Fernández MP, Calvo-Guirado JL, Maté-Sánchez Del Val JE, Delgado-Ruiz RA, Negri B, Barona-Dorado C. Ultrastructural study by backscattered electron imaging and elemental microanalysis of bone-to-biomaterial interface and mineral degradation of porcine xenografts used in maxillary sinus floor elevation. Clin Oral Implants Res 2012; 24:523-30. [PMID: 22276656 DOI: 10.1111/j.1600-0501.2011.02414.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to carry out an ultrastructural study of the biomaterial-to-bone interface and biomaterial mineral degradation in retrieved bone biopsies following maxillary sinus augmentation using collagenized porcine xenografts (Osteobiol(®) Mp3) in 15 clinical cases. MATERIALS AND METHODS Nine months after sinus lifting, bone cores were harvested from the maxillary sinus. The specimens were processed for observation under a scanning electron microscope with backscattered electron imaging (SEM-BSE). In addition, chemical analysis and elemental mapping of the mineral composition were generated using a microanalytical system based on energy-dispersive X-ray spectrometry (EDX). RESULTS No clinical complications were evident during surgery. Scanning electron microscopy revealed that newly formed bone had become closely attached to the xenograft. Statistical analysis showed a significantly high Ca/P ratio in the biomaterial (2.46 ± 0.16) and at the bone interface (2.00 ± 0.48) compared to bone (1.97 ± 0.36), which suggests that there may be a gradual diffusion of Ca ions from the biomaterial into the newly forming bone at the interface as part of the biomaterial's resorption process. EDX analysis of the residual porcine biomaterial at different points showed some particle categories with different mean ratios of Ca/P according to size, pointing to different stages of the resorption process. CONCLUSIONS The biomaterial proved to be biocompatible, bioreabsorbable and osteoconductive when used as a bone substitute for maxillary sinus elevation. SEM-BSE revealed that newly formed bone had become closely attached to the xenografts. EDX analysis monitored the resorption process of the porcine bone xenograft. Elemental mapping showed that there was a gradual diffusion of Ca ions from the biomaterial to the newly forming bone at the interface.
Collapse
|
9
|
Human Maxillary Sinuses Augmented With Mineralized, Solvent-Dehydrated Bone Allograft: A Longitudinal Case Series. IMPLANT DENT 2011; 20:445-54. [DOI: 10.1097/id.0b013e31823420a4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
Cortez PP, Silva MA, Santos M, Armada-da-Silva P, Afonso A, Lopes MA, Santos JD, Maurício AC. A glass-reinforced hydroxyapatite and surgical-grade calcium sulfate for bone regeneration: In vivo biological behavior in a sheep model. J Biomater Appl 2011; 27:201-17. [PMID: 21602251 DOI: 10.1177/0885328211399479] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A glass-reinforced hydroxyapatite (HA) composite (Bonelike®) was developed for bone grafting. This biomaterial is composed of a modified HA matrix with α- and β-tricalcium phosphate secondary phases, resulting in higher solubility than single HA type of materials. Several in vitro and in vivo studies demonstrated that Bonelike® has a highly bioactive behavior, which was also confirmed by employing granular forms of this biomaterial in orthopedics and dental applications. However, a fast consolidation vehicle was needed to promote the fixation of Bonelike® granules if applied in larger defects or in unstable sites. Surgical-grade calcium sulfate (CS), which is widely recognized as a well-tolerated and inexpensive bone graft material, was the chosen vehicle to improve the handling characteristics of Bonelike® as it can be used in the form of a powder that is mixed with a liquid to form a paste that sets in situ. After application in non-critical monocortical defects in sheep, histological, and scanning electron microscopy evaluations demonstrated that Bonelike® associated to CS functioned as a very satisfactory scaffold for bone regeneration as it achieved synchronization of the ingrowing bone with biomaterial resorption and subsequent preservation of the bone graft initial volume. Therefore, our results indicate that CS is an effective vehicle for Bonelike® granules as it facilitates their application and does not interfere with their proven highly osteoconductive properties. In the opposite way, the incorporation of Bonelike® improves the bone regeneration capabilities of CS.
Collapse
Affiliation(s)
- Paulo Pegado Cortez
- Centro de Estudos de Ciência Animal-CECA, Instituto de Ciências e Tecnologias Agrárias e Agro-Alimentares-ICETA, Universidade do Porto, Campus Agrário de Vairão, 4485-661 Vairão, Portugal.
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Calvo-Guirado JL, Delgado-Ruíz RA, Ramírez-Fernández MP, Maté-Sánchez JE, Ortiz-Ruiz A, Marcus A. Retracted:
Histomorphometric and mineral degradation study of Ossceram®
: a novel biphasic B-tricalcium phosphate, in critical size defects in rabbits. Clin Oral Implants Res 2011; 23:667-675. [DOI: 10.1111/j.1600-0501.2011.02193.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
12
|
Dasmah A, Sennerby L, Rasmusson L, Hallman M. Intramembraneous bone tissue responses to calcium sulfate: an experimental study in the rabbit maxilla. Clin Oral Implants Res 2011; 22:1404-8. [DOI: 10.1111/j.1600-0501.2010.02129.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
13
|
Clinical and Histologic Outcomes of Calcium Sulfate in the Treatment of Postextraction Sockets. J Craniofac Surg 2011; 22:494-8. [DOI: 10.1097/scs.0b013e318208bb21] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
14
|
Lindgren C, Hallman M, Sennerby L, Sammons R. Back-scattered electron imaging and elemental analysis of retrieved bone tissue following sinus augmentation with deproteinized bovine bone or biphasic calcium phosphate. Clin Oral Implants Res 2010; 21:924-30. [PMID: 20491837 DOI: 10.1111/j.1600-0501.2010.01933.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To compare resorption of a synthetic biphasic calcium phosphate (BCP) bone-graft substitute with deproteinized bovine bone (DBB) used for human maxillary sinus augmentation. MATERIALS AND METHODS Eleven patients underwent bilateral maxillary sinus floor augmentation with DBB in one side and a BCP (40%beta-tricalcium phosphate (beta-TCP) and 60% hydroxyapatite) in the contralateral side. Simultaneously, with the augmentation on each side a microimplant was placed vertically from the top of the alveolar crest penetrating the residual bone and the grafting material. Eight months after initial surgery the microimplants were retrieved with a surrounding bone core. The composition of residual graft material and surrounding bone was analysed by scanning electron microscopy and energy dispersive X-ray spectroscopy. RESULTS Residual graft material of both types was present as 10-500 mum particles in direct contact with, or completely surrounded by, newly formed bone; smaller particles were also present in non-mineralized tissue. In the case of BCP the bone-graft substitute interface showed evidence of superficial disintegration of particles into individual grains. Median Ca/P ratios (at.%), determined from >200 discreet sites within residual graft particles and adjacent bone, were: DBB: 1.61 (confidence interval [CI] 1.59-1.64); BCP: 1.5 (CI 1.45-1.52); DBB-augmented bone: 1.62 (CI 1.59-1.66); BCP-augmented bone: 1.52 (CI 1.47-1.55); P=0.028 for DBB vs. BCP and DBB- vs. BCP-augmented bone. The reduction in Ca/P ratio for BCP over the healing period is consistent with the dissolution of beta-TCP and reprecipitation on the surface of calcium-deficient hydroxyapatite. CONCLUSION The beta-TCP component of BCP may be gradually substituted by calcium-deficient hydroxyapatite over the healing period. This process and superficial degranulation of BCP particles may influence the progress of resorption and healing.
Collapse
|
15
|
Dasmah A, Hallman M, Sennerby L, Rasmusson L. A Clinical and Histological Case Series Study on Calcium Sulfate for Maxillary Sinus Floor Augmentation and Delayed Placement of Dental Implants. Clin Implant Dent Relat Res 2009; 14:259-65. [DOI: 10.1111/j.1708-8208.2009.00249.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|