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Wang Y, Zong Y, Chen W, Diao N, Zhao Q, Li C, Jia B, Zhang M, Li J, Zhao Y, Du R, He Z. Decellularized Antler Cancellous Bone Matrix Material Can Serve as Potential Bone Tissue Scaffold. Biomolecules 2024; 14:907. [PMID: 39199295 PMCID: PMC11353137 DOI: 10.3390/biom14080907] [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: 06/21/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 09/01/2024] Open
Abstract
Due to the limited supply of autologous bone grafts, there is a need to develop more bone matrix materials to repair bone defects. Xenograft bone is expected to be used for clinical treatment due to its exact structural similarity to natural bone and its high biocompatibility. In this study, decellularized antler cancellous bone matrix (DACB) was first prepared, and then the extent of decellularization of DACB was verified by histological staining, which demonstrated that it retained the extracellular matrix (ECM). The bioactivity of DACB was assessed using C3H10T1/2 cells, revealing that DACB enhanced cell proliferation and facilitated cell adhesion and osteogenic differentiation. When evaluated by implanting DACB into nude mice, there were no signs of necrosis or inflammation in the epidermal tissues. The bone repair effect of DACB was verified in vivo using sika deer during the antler growth period as an animal model, and the molecular mechanisms of bone repair were further evaluated by transcriptomic analysis of the regenerated tissues. Our findings suggest that the low immunogenicity of DACB enhances the production of bone extracellular matrix components, leading to effective osseointegration between bone and DACB. This study provides a new reference for solving bone defects.
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Affiliation(s)
- Yusu Wang
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China; (Y.W.); (Y.Z.); (W.C.); (N.D.); (Q.Z.); (C.L.); (M.Z.); (J.L.); (Y.Z.)
- Institute of Antler Science and Product Technology, Changchun Sci-Tech University, Changchun 130112, China
| | - Ying Zong
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China; (Y.W.); (Y.Z.); (W.C.); (N.D.); (Q.Z.); (C.L.); (M.Z.); (J.L.); (Y.Z.)
| | - Weijia Chen
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China; (Y.W.); (Y.Z.); (W.C.); (N.D.); (Q.Z.); (C.L.); (M.Z.); (J.L.); (Y.Z.)
| | - Naichao Diao
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China; (Y.W.); (Y.Z.); (W.C.); (N.D.); (Q.Z.); (C.L.); (M.Z.); (J.L.); (Y.Z.)
| | - Quanmin Zhao
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China; (Y.W.); (Y.Z.); (W.C.); (N.D.); (Q.Z.); (C.L.); (M.Z.); (J.L.); (Y.Z.)
| | - Chunyi Li
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China; (Y.W.); (Y.Z.); (W.C.); (N.D.); (Q.Z.); (C.L.); (M.Z.); (J.L.); (Y.Z.)
- Institute of Antler Science and Product Technology, Changchun Sci-Tech University, Changchun 130112, China
| | - Boyin Jia
- College of Animal Medicine, College of Animal Science and Technology, Jilin Agricultural University, Changchun 130118, China;
| | - Miao Zhang
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China; (Y.W.); (Y.Z.); (W.C.); (N.D.); (Q.Z.); (C.L.); (M.Z.); (J.L.); (Y.Z.)
| | - Jianming Li
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China; (Y.W.); (Y.Z.); (W.C.); (N.D.); (Q.Z.); (C.L.); (M.Z.); (J.L.); (Y.Z.)
| | - Yan Zhao
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China; (Y.W.); (Y.Z.); (W.C.); (N.D.); (Q.Z.); (C.L.); (M.Z.); (J.L.); (Y.Z.)
| | - Rui Du
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China; (Y.W.); (Y.Z.); (W.C.); (N.D.); (Q.Z.); (C.L.); (M.Z.); (J.L.); (Y.Z.)
| | - Zhongmei He
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China; (Y.W.); (Y.Z.); (W.C.); (N.D.); (Q.Z.); (C.L.); (M.Z.); (J.L.); (Y.Z.)
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Huang Y, Xu Y, Huang Z, Mao J, Hui Y, Rui M, Jiang X, Wu J, Ding Z, Feng Y, Gu Y, Chen L. Melatonin and calcium phosphate crystal-loaded poly(L-lactic acid) porous microspheres reprogram macrophages to improve bone repair. J Mater Chem B 2024. [PMID: 38940905 DOI: 10.1039/d3tb02965d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
The bone immune microenvironment can influence the occurrence and progression of bone defects. To date, research on promoting macrophage M2 polarization to improve bone injury repair has been insufficient. In this study, we designed an injectable poly(L-lactic acid) (PLLA) porous microsphere that forms calcium phosphate crystals on its surface by binding to melatonin, followed by bionanomimetic mineralization in vitro. The microsphere is injectable and degradable, and its release of melatonin (MT) and calcium phosphate (CaP) crystals promotes macrophage M2 polarization, reprogramming of macrophages, and enhanced osteogenesis. After LPS stimulation, the proportion of M2-polarized macrophages in the MS@CaP@MT group was 39.2 ± 2.7%, significantly higher than that in other groups (P < 0.05). Further, in the MS@CaP@MT group, rats exhibited bone mineral densities of 129.4 ± 12.8 mg cc-1 at 2 weeks and 171.6 ± 13.6 mg cc-1 at 4 weeks in the defect area, which were significantly higher than those in other groups (P < 0.05). Using an animal model of femoral condylar defects, we demonstrated that MT PLLA porous microspheres loaded with calcium phosphate crystals can improve the immune microenvironment and form a microsphere-centered osteogenesis model. This significantly accelerates bone defect repair and provides a potential strategy for bone defect treatment.
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Affiliation(s)
- Yiyang Huang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute, Soochow University, 188 Shizi Road, Suzhou, Jiangsu, 215006, PR China.
| | - Yichang Xu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute, Soochow University, 188 Shizi Road, Suzhou, Jiangsu, 215006, PR China.
| | - Ziyan Huang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute, Soochow University, 188 Shizi Road, Suzhou, Jiangsu, 215006, PR China.
| | - Jiannan Mao
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute, Soochow University, 188 Shizi Road, Suzhou, Jiangsu, 215006, PR China.
- Department of Orthopaedics, Jiangyin Clinical College, Xuzhou Medical University, No. 163 Shoushan Road, Jiang Yin 214400, China
| | - Yujian Hui
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute, Soochow University, 188 Shizi Road, Suzhou, Jiangsu, 215006, PR China.
- Department of Orthopaedics, Jiangyin Clinical College, Xuzhou Medical University, No. 163 Shoushan Road, Jiang Yin 214400, China
| | - Min Rui
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute, Soochow University, 188 Shizi Road, Suzhou, Jiangsu, 215006, PR China.
- Department of Orthopaedics, Jiangyin Clinical College, Xuzhou Medical University, No. 163 Shoushan Road, Jiang Yin 214400, China
| | - Xinzhao Jiang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute, Soochow University, 188 Shizi Road, Suzhou, Jiangsu, 215006, PR China.
| | - Jie Wu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute, Soochow University, 188 Shizi Road, Suzhou, Jiangsu, 215006, PR China.
| | - Zhouye Ding
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute, Soochow University, 188 Shizi Road, Suzhou, Jiangsu, 215006, PR China.
| | - Yu Feng
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute, Soochow University, 188 Shizi Road, Suzhou, Jiangsu, 215006, PR China.
| | - Yong Gu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute, Soochow University, 188 Shizi Road, Suzhou, Jiangsu, 215006, PR China.
| | - Liang Chen
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute, Soochow University, 188 Shizi Road, Suzhou, Jiangsu, 215006, PR China.
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Wang J, Zhang L, Wang K. Bioactive ceramic-based materials: beneficial properties and potential applications in dental repair and regeneration. Regen Med 2024; 19:257-278. [PMID: 39118532 PMCID: PMC11321270 DOI: 10.1080/17460751.2024.2343555] [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: 12/04/2023] [Accepted: 04/12/2024] [Indexed: 08/10/2024] Open
Abstract
Bioactive ceramics, primarily consisting of bioactive glasses, glass-ceramics, calcium orthophosphate ceramics, calcium silicate ceramics and calcium carbonate ceramics, have received great attention in the past decades given their biocompatible nature and excellent bioactivity in stimulating cell proliferation, differentiation and tissue regeneration. Recent studies have tried to combine bioactive ceramics with bioactive ions, polymers, bioactive proteins and other chemicals to improve their mechanical and biological properties, thus rendering them more valid in tissue engineering scaffolds. This review presents the beneficial properties and potential applications of bioactive ceramic-based materials in dentistry, particularly in the repair and regeneration of dental hard tissue, pulp-dentin complex, periodontal tissue and bone tissue. Moreover, greater insights into the mechanisms of bioactive ceramics and the development of ceramic-based materials are provided.
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Affiliation(s)
- Jiale Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No.14, Section 3rd of Renmin South Road, Chengdu, 610041, China
| | - Linglin Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No.14, Section 3rd of Renmin South Road, Chengdu, 610041, China
| | - Kun Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No.14, Section 3rd of Renmin South Road, Chengdu, 610041, China
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Okamura A, Hiratsuka T, Fushimi H, Nishimura I. Recombinant bone matrix maintains the graft space, induces vascularized bone regeneration and preserves canine tooth extraction socket structure. J Clin Periodontol 2024; 51:338-353. [PMID: 38110189 DOI: 10.1111/jcpe.13915] [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: 08/10/2023] [Revised: 10/22/2023] [Accepted: 11/24/2023] [Indexed: 12/20/2023]
Abstract
AIM Recombinant bone matrix (RBM) is a newly conceived and engineered porous bone graft granule of average size 600 μm composed of purified recombinant collagen peptide. We sought to examine the behaviour with time of RBM that was grafted in the canine tooth extraction socket. MATERIALS AND METHODS The canine tooth extraction socket of the hemisectioned mandibular third premolar distal root was grafted with RBM granules, whereas the opposite side extraction socket served as non-grafted control. The mandibular samples were harvested at 1, 3 and 6 months of healing and subjected to micro-CT imaging and decalcified paraffin-embedded histology. Separately, the effect of RBM was compared with that of deproteinized cancellous bovine bone (DCBB) and bovine atelocollagen plug (BACP) in the canine tooth extraction model at 3 months of healing. RESULTS RBM maintained the grafted space in the socket and the gingival connective tissue until new bone was formed within its porous space. The regenerated bone was highly vascularized and continued to mature, while RBM was completely bioresorbed by 6 months. The buccal and lingual alveolar ridge heights of the RBM-grafted extraction socket was better preserved than those of non-grafted control sockets. The degree of socket preservation by RBM was equivalent to that by DCBB, although their healing mechanisms were different. CONCLUSIONS This study demonstrated that RBM induced controlled active bone regeneration and preserved the extraction socket structure in a canine model. Bioresorbable RBM engineered without animal or human source materials presents a novel bone graft category with robust bone regenerative property.
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Affiliation(s)
- Ai Okamura
- Bio Science & Engineering Laboratories, FUJIFILM Corporation, Kanagawa, Japan
| | - Takahiro Hiratsuka
- Bio Science & Engineering Laboratories, FUJIFILM Corporation, Kanagawa, Japan
| | - Hideo Fushimi
- Bio Science & Engineering Laboratories, FUJIFILM Corporation, Kanagawa, Japan
| | - Ichiro Nishimura
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, California, USA
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Abdulaziz D, Anastasiou AD, Panagiotopoulou V, Raif EM, Giannoudis PV, Jha A. Physiologically engineered porous titanium/brushite scaffolds for critical-size bone defects: A design and manufacturing study. J Mech Behav Biomed Mater 2023; 148:106223. [PMID: 37976684 DOI: 10.1016/j.jmbbm.2023.106223] [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: 09/13/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
Repairing critical-size bone defects still represents a critical clinical challenge in the field of trauma surgery. This study focuses on a physiological design and manufacturing of porous composite scaffold (titanium Ti with 10 % mole iron doped brushite DCPD-Fe3+) which can mimic the biomechanical properties of natural cortical bone, specifically for the purpose of repairing critical-size defects. To achieve this, the principle of design of experiments (DOE) was applied for investigating the impact of sintering temperature, mineral ratio, and volume fraction of porosity on the mechanical properties of the fabricated scaffolds. The fabricated scaffolds had open porosity up to 60 %, with pore size approximately between 100 μm and 850 μm. The stiffness of the porous composite scaffolds varied between 3.30 GPa and 20.50 GPa, while the compressive strength ranged from approximately 130 MPa-165 MPa at sintering temperatures equal to or exceeding 1000 °C. Scaffolds with higher porosity and mineral content demonstrated lower stiffness values, resembling natural bone. Numerical simulation was employed by Ansys Workbench to investigate the stress and strain distribution of a critical size defect in mid-shaft femur which was designed to be replaced with the fabricated scaffold. The fabricated scaffolds showed flexible biomechanical behaviour at the bone/scaffold interface, generating lower stress levels and indicating a better match with the femoral shaft stiffness. The experimental and numerical findings demonstrated promising applications for manufacturing a patient-specific bone scaffold for critical and potentially large defects for reducing stress shielding and minimizing non-union risk.
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Affiliation(s)
- Dina Abdulaziz
- School of Chemical and Process Engineering, University of Leeds, Leeds, LS2 9JT, UK.
| | - Antonios D Anastasiou
- Department of Chemical Engineering, University of Manchester, Manchester, M1 3AL, UK
| | | | - El Mostafa Raif
- Faculty of Medicine and Health, School of Dentistry, University of Leeds, Leeds, LS2 9JT, UK
| | - Peter V Giannoudis
- Academic Department of Trauma and Orthopaedic Surgery, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Animesh Jha
- School of Chemical and Process Engineering, University of Leeds, Leeds, LS2 9JT, UK
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Roldan L, Isaza C, Ospina J, Montoya C, Domínguez J, Orrego S, Correa S. A Comparative Study of HA/DBM Compounds Derived from Bovine and Porcine for Bone Regeneration. J Funct Biomater 2023; 14:439. [PMID: 37754853 PMCID: PMC10532284 DOI: 10.3390/jfb14090439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/25/2023] [Accepted: 08/17/2023] [Indexed: 09/28/2023] Open
Abstract
This comparative study investigated the tissue regeneration and inflammatory response induced by xenografts comprised of hydroxyapatite (HA) and demineralized bone matrix (DBM) extracted from porcine (P) and bovine (B) sources. First, extraction of HA and DBM was independently conducted, followed by chemical and morphological characterization. Second, mixtures of HA/DBM were prepared in 50/50 and 60/40 concentrations, and the chemical, morphological, and mechanical properties were evaluated. A rat calvarial defect model was used to evaluate the tissue regeneration and inflammatory responses at 3 and 6 months. The commercial allograft DBM Puros® was used as a clinical reference. Different variables related to tissue regeneration were evaluated, including tissue thickness regeneration (%), amount of regenerated bone area (%), and amount of regenerated collagen area (%). The inflammatory response was evaluated by quantifying the blood vessel area. Overall, tissue regeneration from porcine grafts was superior to bovine. After 3 months of implantation, the tissue thickness regeneration in the 50/50P compound and the commercial DBM was significantly higher (~99%) than in the bovine materials (~23%). The 50/50P and DBM produced higher tissue regeneration than the naturally healed controls. Similar trends were observed for the regenerated bone and collagen areas. The blood vessel area was correlated with tissue regeneration in the first 3 months of evaluation. After 6 months of implantation, HA/DBM compounds showed less regenerated collagen than the DBM-only xenografts. In addition, all animal-derived xenografts improved tissue regeneration compared with the naturally healed defects. No clinical complications associated with any implanted compound were noted.
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Affiliation(s)
- Lina Roldan
- Grupo de Investigación en Bioingeniería (GIB), Universidad EAFIT, Medellín 050022, Colombia; (L.R.); (C.I.)
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, PA 19122, USA; (C.M.); (S.O.)
| | - Catalina Isaza
- Grupo de Investigación en Bioingeniería (GIB), Universidad EAFIT, Medellín 050022, Colombia; (L.R.); (C.I.)
| | - Juan Ospina
- Centro de Investigación y Desarrollo Cárnico, Industrias de Alimentos Zenú S.A.S., Grupo Nutresa, Medellín 050044, Colombia;
| | - Carolina Montoya
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, PA 19122, USA; (C.M.); (S.O.)
| | - José Domínguez
- Grupo de Investigación en Bioingeniería (GIB), Universidad EAFIT, Medellín 050022, Colombia; (L.R.); (C.I.)
| | - Santiago Orrego
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, PA 19122, USA; (C.M.); (S.O.)
- Bioengineering Department, College of Engineering, Temple University, Philadelphia, PA 191122, USA
| | - Santiago Correa
- Grupo de Investigación en Bioingeniería (GIB), Universidad EAFIT, Medellín 050022, Colombia; (L.R.); (C.I.)
- Escuela de Ciencias Aplicadas e Ingeniería, Universidad EAFIT, Medellín 050022, Colombia
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Al Qabbani A, Rani KGA, Syarif J, AlKawas S, Sheikh Abdul Hamid S, Samsudin AR, Azlina A. Evaluation of decellularization process for developing osteogenic bovine cancellous bone scaffolds in-vitro. PLoS One 2023; 18:e0283922. [PMID: 37018321 PMCID: PMC10075422 DOI: 10.1371/journal.pone.0283922] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 03/21/2023] [Indexed: 04/06/2023] Open
Abstract
Current immunological issues in bone grafting regarding the transfer of xenogeneic donor bone cells into the recipient are challenging the industry to produce safer acellular natural matrices for bone regeneration. The aim of this study was to investigate the efficacy of a novel decellularization technique for producing bovine cancellous bone scaffold and compare its physicochemical, mechanical, and biological characteristics with demineralized cancellous bone scaffold in an in-vitro study. Cancellous bone blocks were harvested from a bovine femoral head (18-24 months old) subjected to physical cleansing and chemical defatting, and further processed in two ways. Group I was subjected to demineralization, while Group II underwent decellularization through physical, chemical, and enzymatic treatments. Both were then freeze-dried, and gamma radiated, finally producing a demineralized bovine cancellous bone (DMB) scaffold and decellularized bovine cancellous bone (DCC) scaffold. Both DMB and DCC scaffolds were subjected to histological evaluation, scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM/EDS), fourier-transform infrared spectroscopy (FTIR), quantification of lipid, collagen, and residual nucleic acid content, and mechanical testing. The osteogenic potential was investigated through the recellularization of scaffolds with human osteoblast cell seeding and examined for cell attachment, proliferation, and mineralization by Alizarin staining and gene expression. DCC produced a complete acellular extracellular matrix (ECM) with the absence of nucleic acid content, wider pores with extensive interconnectivity and partially retaining collagen fibrils. DCC demonstrated a higher cell proliferation rate, upregulation of osteogenic differentiation markers, and substantial mineralized nodules production. Our findings suggest that the decellularization technique produced an acellular DCC scaffold with minimal damage to ECM and possesses osteogenic potential through the mechanisms of osteoconduction, osteoinduction, and osteogenesis in-vitro.
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Affiliation(s)
- Ali Al Qabbani
- Department of Oral & Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Basic Science and Oral Biology Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - K. G. Aghila Rani
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Junaidi Syarif
- Department of Nuclear and Mechanical Engineering, College of Engineering, University of Sharjah, Sharjah, United Arab Emirates
| | - Sausan AlKawas
- Department of Oral & Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Suzina Sheikh Abdul Hamid
- Tissue Bank, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - A. R. Samsudin
- Department of Oral & Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Tissue Bank, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Ahmad Azlina
- Basic Science and Oral Biology Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Minaichev V, Smirnova P, Senotov A, Teterina A, Fadeeva I. Remineralization of Demineralized Bone Matrixes with Preserved Fibrillary Structure as a Promising Approach to Obtain Highly Effective Osteoplastic Materials. BIO WEB OF CONFERENCES 2023. [DOI: 10.1051/bioconf/20235704001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The development of highly effective osteoplastic materials capable of providing bone tissue regeneration still remains an urgent and unresolved problem. In the presented work, an approach is proposed for the creation of biomimetic materials by the deposition of amorphous calcium phosphates on the surface of a xenogenic bone demineralized matrix under physiological conditions. Adsorption spectroscopy and scanning electron microscopy showed the efficiency of deposition of amorphous calcium phosphates on the trabeculae surface. The additional inclusion of the calcium-binding protein albumin was found to increase the efficiency of CPC adsorption on the trabeculae surface during DBM remineralization in vitro. In the model of heterotopic implantation for 7 weeks the osteoinductive properties of the obtained material were demonstrated, expressed in intrabecular mineralization of bone trabeculae, neovascularization and pronounced synthetic activity of osteoblasts (synthesis and structurization of neocollagen directly on the implanted material). The data obtained in the course of this work will be used to create new highly effective osteoplastic materials.
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9
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Domínguez-Hernández VM, Hernández-Flores C, Delgado A, Valdez-Mijares R, Araujo-Monsalvo VM, Hernández-González O. Effect of ascorbic acid and epidermal growth factor in a rat tibia defect. Acta Cir Bras 2023; 38:e381623. [PMID: 37132758 PMCID: PMC10159014 DOI: 10.1590/acb381623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 02/28/2023] [Indexed: 05/04/2023] Open
Abstract
PURPOSE Bone repair aims to restore the anatomical, biomechanical, and functional integrity of the affected structure. Here we study the effects of ascorbic acid (AA) and epidermal growth factor (EGF) applied in a single dose and in combination on the repair of a noncritical bone defect model. METHODS Twenty-four rats were divided into four groups: an intact G-1 control group, and three groups that underwent a noncritical bone defect in the right tibia: G-2 treated with AA, G-3 treated with EGF, and G-4 treated with AA in combination with EGF. After 21 days of treatment, rats were sacrificed, the tibias were dissected and a destructive biomechanical analysis of three-point flexion test was performed in a universal testing machine; the values of stiffness, resistance, maximum energy, and energy at maximum load were statistically compared. RESULTS G-3 and G-4 recovered the biomechanical properties of strength and stiffness of an intact tibia 3 weeks after their application. Not so the energy and energy at maximum load. For G-2, only the stiffness of an intact tibia was recovered. CONCLUSIONS EGF and AA-EGF applied to a noncritical bone defect in the rat tibia favors the recovery of bone resistance and stiffness.
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Affiliation(s)
| | - Cecília Hernández-Flores
- Instituto Nacional de Rehabilitación LGII - Laboratorio de Bioquímica - Ciudad de México, México
| | - Alfonso Delgado
- Universidad Autónoma de Chihuahua - Facultad de Medicina y Ciencias Biomédicas - Departamento de Fisiología - Chihuahua, México
| | - Rene Valdez-Mijares
- Instituto Nacional de Rehabilitación LGII - Laboratorio de Bioquímica - Ciudad de México, México
| | - Victor M Araujo-Monsalvo
- Instituto Nacional de Rehabilitación LGII - Laboratorio de Biomecánica - Ciudad de México, México
| | - Olivia Hernández-González
- Instituto Nacional de Rehabilitación LGII - Laboratorio de Microscopía Electrónica - Ciudad de México, México
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10
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Chiu YL, Luo YL, Chen YW, Wu CT, Periasamy S, Yen KC, Hsieh DJ. Regenerative Efficacy of Supercritical Carbon Dioxide-Derived Bone Graft Putty in Rabbit Bone Defect Model. Biomedicines 2022; 10:2802. [PMID: 36359322 PMCID: PMC9687147 DOI: 10.3390/biomedicines10112802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 12/01/2023] Open
Abstract
Bone defects can arise from numerous reasons, such as aging, tumor, trauma, infection, surgery, and congenital diseases. Bone grafts are commonly used as a substitute to fill the void and regenerate the defect. Due to its clean and green technology, the supercritical carbon dioxide (SCCO2) extraction aided the production of bone grafts is a recent trend. The SCCO2-derived bone graft has osteoconductive and osteoinductive properties along with excellent biocompatible, nontoxic, bioabsorbable, osteoconductive, and good mechanical properties; however, clinical usage during surgery is time-consuming. Therefore, we produced a putty material combining bone graft powder and acellular dermal matrix (ADM) powder and tested its regenerative efficacy in the critical defect in the rabbit model. The putty was found to retain the tubular structure. In addition, the putty depicted excellent stickiness and cohesiveness in both saline and blood medium. The bone regeneration of bone graft and putty was similar; both had excellent bone healing and regeneration of critical defects as evaluated by the X-ray, microtomography, hematoxylin-eosin, Masson trichrome, and alizarin red staining. Putty contains a less washout rate, good mechanical strength, and biocompatibility. In conclusion, the SCCO2-derived moldable putty could be a promising easy-to-use alternative for bone grafts at present which might have real-world usage in orthopedics as a potential bone void filler and dental socket preservation.
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Affiliation(s)
- Yen-Lung Chiu
- Department of Life Sciences, National Cheng Kung University, Tainan 70101, Taiwan
| | - Yun-Li Luo
- Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, Taipei City 110, Taiwan
- School of Dentistry, National Defense Medical Center, Taipei City 11490, Taiwan
- R&D Center, ACRO Biomedical Co., Ltd., Kaohsiung 82151, Taiwan
| | - Yuan-Wu Chen
- Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, Taipei City 110, Taiwan
- School of Dentistry, National Defense Medical Center, Taipei City 11490, Taiwan
| | - Chi-Tsung Wu
- Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, Taipei City 110, Taiwan
- School of Dentistry, National Defense Medical Center, Taipei City 11490, Taiwan
| | | | - Ko-Chung Yen
- R&D Center, ACRO Biomedical Co., Ltd., Kaohsiung 82151, Taiwan
| | - Dar-Jen Hsieh
- R&D Center, ACRO Biomedical Co., Ltd., Kaohsiung 82151, Taiwan
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11
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Wang W, Lu J, Song Y, Zeng C, Wang Y, Yang C, Huang B, Dai Y, Yang J, Lai L, Wang L, Cai D, Bai X. Repair of bone defects in rhesus monkeys with α1,3-galactosyltransferase-knockout pig cancellous bone. Front Bioeng Biotechnol 2022; 10:990769. [PMID: 36172016 PMCID: PMC9510634 DOI: 10.3389/fbioe.2022.990769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 08/18/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction: Since xenografts offer a wide range of incomparable advantages, they can be a better option than allografts but only if the possibility of immunological rejection can be eliminated. In this study, we investigated the ability of α1,3-galactosyltransferase (α1,3-GT) gene knockout (GTKO) pig cancellous bone to promote the repair of a femoral condyle bone defect and its influence on heterologous immune rejection. Materials and methods: Cylindrical bone defects created in a rhesus monkey model were transplanted with GTKO bone, WT bone or left empty. For immunological evaluation, T lymphocyte subsets CD4+ and CD8+ in peripheral blood were assayed by flow cytometry, and the IL-2 and IFN-γ contents of peripheral blood serum were analyzed by ELISA at 2, 5, 7, 10, and 14 days post-surgery. Micro-CT scans and histological assessment were conducted at 4 and 8 weeks after implantation. Results: Compared with WT-pig bone, the heterologous immunogenicity of GTKO-pig bone was reduced. The defect filled with fresh GTKO-pig bone was tightly integrated with the graft. Histological analysis showed that GTKO-pig cancellous bone showed better osseointegration and an appropriate rate of resorption. Osteoblast phenotype progression in the GTKO group was not affected, which revealed that GTKO-pig bone could not only fill and maintain the bone defect, but also promote new bone formation. Conclusion: GTKO-pig cancellous bone decreased the ratio of CD4+ to CD8+ T cells and cytokines (IFN-γ and IL-2) to inhibit xenotransplant rejection. Moreover, GTKO group increased more bone formation by micro-CT analysis and osteoblastic markers (Runx2, OSX and OCN). Together, GTKO-pig cancellous bone showed better bone repair than WT-pig cancellous bone.
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Affiliation(s)
- Wenhao Wang
- Department of Orthopaedics, Shandong Provincial Hospital Affliated to Shandong First Medical University, Jinan, China
| | - Jiansen Lu
- Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Department of Joint Surgery, The Fifth Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
- Department of Immunology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Ying Song
- Department of Endodontics, Jinan Stomatological Hospital, Jinan, China
| | - Chun Zeng
- Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yongkui Wang
- Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Cheng Yang
- Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Bin Huang
- Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yifan Dai
- State Key Laboratory of Reproductive Medicine, Jiangsu Key Laboratory of Xenotransplantation, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jian Yang
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Liangxue Lai
- Key Laboratory of Regenerative Biology, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong, China
| | - Liping Wang
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Daozhang Cai
- Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China
- *Correspondence: Daozhang Cai, ; Xiaochun Bai,
| | - Xiaochun Bai
- Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Department of Cell Biology, School of Basic Medical Science, Southern Medical University, Guangzhou, China
- *Correspondence: Daozhang Cai, ; Xiaochun Bai,
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12
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Beyond the pedicle screw-a patent review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:1553-1565. [PMID: 35380271 DOI: 10.1007/s00586-022-07193-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This review provides an overview of the patent literature on posteriorly placed intrapedicular bone anchors. Conventional pedicle screws are the gold standard to create a fixation in the vertebra for spinal fusion surgery but may lack fixation strength, especially in osteoporotic bone. The ageing population demands new bone anchors that have an increased fixation strength, that can be placed safely, and, if necessary, can be removed without damaging the surrounding tissue. METHODS The patent search was conducted using a classification search in the Espacenet patent database. Only patents with a Cooperative Patent Classification of A61B17/70 or A61B17/7001 concerning spinal positioners and stabilizers were eligible for inclusion. The search query resulted in the identification of 731 patents. Based on preset inclusion criteria, a total of 56 unique patents on different anchoring methods were included, reviewed and categorized in this study. RESULTS Five unique fixation methods were identified; (1) anchors that use threading, (2) anchors that utilize a curved path through the vertebra, (3) anchors that (partly) expand, (4) anchors that use cement and (5) anchors that are designed to initiate bone ingrowth. Of the anchor designs included in this study, eight had a corresponding commercial product, six of which were evaluated in clinical trials. CONCLUSION This review provides insights into worldwide patented intrapedicular bone anchors that aim to increase the fixation strength compared to the conventional pedicle screw. The identified anchoring methods and their working principles can be used for clinical decision-making and as a source of inspiration when designing novel bone anchors.
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Roohani I, No YJ, Zuo B, Xiang SD, Lu Z, Liu H, Plebanski M, Zreiqat H. Low-Temperature Synthesis of Hollow β-Tricalcium Phosphate Particles for Bone Tissue Engineering Applications. ACS Biomater Sci Eng 2022; 8:1806-1815. [PMID: 35405073 DOI: 10.1021/acsbiomaterials.1c01018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
β-Tricalcium phosphate (β-TCP) has been extensively used in bone tissue engineering in the form of scaffolds, granules, or as reinforcing phase in organic matrices. Solid-state reaction route at high temperatures (>1000 °C) is the most widely used method for the preparation of β-TCP. The high-temperature synthesis, however, results in the formation of hard agglomerates and fused particles which necessitates postprocessing steps such as milling and sieving operations. This, inadvertently, could lead to introducing unwanted trace elements, promoting particle shape irregularity as well as compromising the biodegradability and bioactivity of β-TCP because of the solid microstructure of particles. In this study, we introduce a one-pot wet-chemical method at low temperatures (between 160 and 170 °C) to synthesize hollow β-TCP (hβ-TCP) submicron particles of an average size of 300 nm with a uniform rhombohedral shape. We assessed the cytocompatibility of the hβ-TCP using primary human osteoblasts (HOB), adipose-derived stem cells (ADSC), and antigen-presenting cells (APCs). We demonstrate the bioactivity of the hβ-TCP when cultured with HOB, ADSC, and APCs at a range of particle concentrations (up to 1000 μg/mL) for up to 7 days. hβ-TCP significantly enhances osteogenic differentiation of ADSC without the addition of osteogenic supplements. These findings offer a new type of β-TCP particles prepared at low temperatures, which present various opportunities for developing β-TCP based biomaterials.
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Affiliation(s)
- Iman Roohani
- Australian Research Council Training Centre for Innovative BioEngineering, Sydney, New South Wales 2006, Australia.,School of Biomedical Engineering, University of Sydney, Sydney, New South Wales 2006, Australia.,School of Chemistry, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Young Jung No
- Australian Research Council Training Centre for Innovative BioEngineering, Sydney, New South Wales 2006, Australia.,School of Biomedical Engineering, University of Sydney, Sydney, New South Wales 2006, Australia
| | - Betty Zuo
- School of Biomedical Engineering, University of Sydney, Sydney, New South Wales 2006, Australia
| | - Sue D Xiang
- Department of Immunology and Pathology, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria 3052, Australia
| | - Zufu Lu
- Australian Research Council Training Centre for Innovative BioEngineering, Sydney, New South Wales 2006, Australia.,School of Biomedical Engineering, University of Sydney, Sydney, New South Wales 2006, Australia
| | - Hongwei Liu
- Australian Centre for Microscopy and Microanalysis, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Magdalena Plebanski
- Department of Immunology and Pathology, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria 3052, Australia.,School of Health and Biomedical Sciences, RMIT University, Bundoora, Melbourne, Victoria 3084, Australia
| | - Hala Zreiqat
- Australian Research Council Training Centre for Innovative BioEngineering, Sydney, New South Wales 2006, Australia.,School of Biomedical Engineering, University of Sydney, Sydney, New South Wales 2006, Australia
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14
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van Oirschot BAJA, Geven EJW, Mikos AG, van den Beucken JJJP, Jansen JA. A Mini-Pig Mandibular Defect Model for Evaluation of Craniomaxillofacial Bone Regeneration. Tissue Eng Part C Methods 2022; 28:193-201. [PMID: 35262400 PMCID: PMC9271328 DOI: 10.1089/ten.tec.2022.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Craniomaxillofacial bone defects represent a clinical challenge in the fields of maxillofacial surgery and (implant) dentistry. Regeneration of these bone defects requires the application of bone graft materials that facilitate new bone formation in a safe, reliable, and predictive manner. In addition to autologous bone graft, several types of (synthetic) bone substitute materials have become clinically available, and still major efforts are focused on improving such bone substitute materials by optimizing their properties. Given the regulatory necessity to evaluate the performance of new bone substitute materials for craniomaxillofacial bone regeneration in a large animal model with similarity to human bone before clinical application, we here describe a mini-pig mandibular bone defect model that allows for the creation of multiple (critical-size) bone defects within the mandibular body of a single animal. As examples of bone substitute materials, we utilize both the clinically used BioOss granules and an experimental calcium phosphate cement for filling the created defects. Regarding the latter, its advantages are the injectable application within the defect site, in which the material rapidly sets, and the tailorable degradation properties via the inclusion of hydrolytically degrading polymeric particles. For both bone substitute materials, we show the suitability of the bone defect model to assess bone regeneration via histology and micro-computed tomography. Impact statement Given the regulatory necessity to evaluate the performance of new bone substitute materials for craniomaxillofacial bone regeneration in a large animal model with similarity to the human bone before clinical application, we here describe a mini-pig mandibular bone defect model that allows for the creation of multiple (critical-size) bone defects within the mandibular body of a single animal that can be used for the evaluation of the bone regenerative capacity of new bone grafting materials as well as tissue-engineered products for alveolar bone regeneration.
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Affiliation(s)
| | | | - Antonios G Mikos
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | | | - John A Jansen
- Department of Dentistry, Biomaterials, Radboudumc, Nijmegen, The Netherlands
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15
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Jain G, Blaauw D, Chang S. A Comparative Study of Two Bone Graft Substitutes–InterOss® Collagen and OCS-B Collagen®. J Funct Biomater 2022; 13:jfb13010028. [PMID: 35323228 PMCID: PMC8951741 DOI: 10.3390/jfb13010028] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 02/05/2023] Open
Abstract
Bone is a complex hierarchical tissue composed of organic and inorganic materials that provide structure, support, and protection to organs. However, there are some critical size defects that are unable to regenerate on their own and therefore require clinical repair. Bone graft substitutes allow repair by providing a temporary resorbable device. Among the common filler materials that aid in regeneration is hydroxyapatite particles of either animal or human origin which is used to fill or reconstruct periodontal and bony defects in the mouth. However, particulate graft substitutes suffer from localized migration away from the implantation site, necessitating the use of a barrier membrane. In this study, we designed InterOss Collagen, combining bovine hydroxyapatite granules with porcine-skin derived collagen to form a bone filler composite. Physiochemical properties of InterOss Collagen and a commercially available product, OsteoConductive Substitute-Bovine(OCS-B) Collagen, referred to as OCS-B Collagen, were examined. We found two bone graft substitutes to be mostly similar, though InterOss Collagen showed comparatively higher surface area and porosity. We conducted an in vivo study in rabbits to evaluate local tissue responses, percent material resorption and bone formation and showed that the two materials exhibited similar degradation profiles, inflammatory and healing responses following implantation. Based on these results, InterOss Collagen is a promising dental bone grafting material for periodontal and maxillofacial surgeries.
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16
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Ghanbari E, Mehdipour A, Khazaei M, Khoshfeterat AB, Niknafs B. A review of recent advances on osteogenic applications of Silk fibroin as a potential bio-scaffold in bone tissue engineering. INT J POLYM MATER PO 2022. [DOI: 10.1080/00914037.2022.2032707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Elham Ghanbari
- Department of Tissue Engineering, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Mehdipour
- Department of Tissue Engineering, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mozafar Khazaei
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Tissue Engineering, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Behrooz Niknafs
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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17
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Alvarez Echazú MI, Perna O, Olivetti CE, Antezana PE, Municoy S, Tuttolomondo MV, Galdopórpora JM, Alvarez GS, Olmedo DG, Desimone MF. Recent Advances in Synthetic and Natural Biomaterials-Based Therapy for Bone Defects. Macromol Biosci 2022; 22:e2100383. [PMID: 34984818 DOI: 10.1002/mabi.202100383] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/04/2021] [Indexed: 12/31/2022]
Abstract
Synthetic and natural biomaterials are a promising alternative for the treatment of critical-sized bone defects. Several parameters such as their porosity, surface, and mechanical properties are extensively pointed out as key points to recapitulate the bone microenvironment. Many biomaterials with this pursuit are employed to provide a matrix, which can supply the specific environment and architecture for an adequate bone growth. Nevertheless, some queries remain unanswered. This review discusses the recent advances achieved by some synthetic and natural biomaterials to mimic the native structure of bone and the manufacturing technology applied to obtain biomaterial candidates. The focus of this review is placed in the recent advances in the development of biomaterial-based therapy for bone defects in different types of bone. In this context, this review gives an overview of the potentialities of synthetic and natural biomaterials: polyurethanes, polyesters, hyaluronic acid, collagen, titanium, and silica as successful candidates for the treatment of bone defects.
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Affiliation(s)
- María I Alvarez Echazú
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina.,Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Marcelo T. de Alvear 2142 (1122), CABA, Argentina
| | - Oriana Perna
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| | - Christian E Olivetti
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| | - Pablo E Antezana
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| | - Sofia Municoy
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| | - María V Tuttolomondo
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| | - Juan M Galdopórpora
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| | - Gisela S Alvarez
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| | - Daniel G Olmedo
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Marcelo T. de Alvear 2142 (1122), CABA, Argentina.,CONICET, Consejo Nacional de Investigaciones Científicas y Técnicas, Godoy Cruz 2290, Buenos Aires, 1425, Argentina
| | - Martín F Desimone
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
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18
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Li C, Lv H, Du Y, Zhu W, Yang W, Wang X, Wang J, Chen W. Biologically modified implantation as therapeutic bioabsorbable materials for bone defect repair. Regen Ther 2021; 19:9-23. [PMID: 35024389 PMCID: PMC8732753 DOI: 10.1016/j.reth.2021.12.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/08/2021] [Accepted: 12/20/2021] [Indexed: 12/26/2022] Open
Abstract
For decades, researches have concentrated on the mechanical properties, biodegradation, and biocompatibility of implants used in the therapy of large size bone defect. In vivo studies demonstrate that bioabsorbable bone substitute materials can reduce the risk of common symptoms such as inflammation and osteonecrosis caused by bio-inert materials after long-term implantation. Several organic, inorganic, and composite materials have been approved for clinical application, based on their unique characteristics and advantages. Although some artificial bioabsorbable bone substitute materials have been used for years, there are still some disadvantages existing, such as low mechanical strength, high brittleness, and low degradation rate. Therefore, novel bioabsorbable composite materials biomaterials have been developed for bone defect repair. In this review, we provide an overview of the development of artificial bioabsorbable bone substitute materials and highlight the advantages and disadvantages. Furthermore, recent advances in bioabsorbable bone substitute materials used in bone defect repair are outlined. Finally, we discuss current challenges and further developments in the clinical application of bioabsorbable bone substitute materials.
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Affiliation(s)
- Chao Li
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China
| | - Hongzhi Lv
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China
| | - Yawei Du
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, PR China
| | - Wenbo Zhu
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China
| | - Weijie Yang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China
| | - Xiumei Wang
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, No.30 Shuangqing Road, Beijing 100084, PR China
| | - Juan Wang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Corresponding author. No.139 Ziqiang Road, Shjiazhuang 050051, PR China. Fax: +86-311-87023626.
| | - Wei Chen
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Corresponding author. No.139 Ziqiang Road, Shjiazhuang 050051, PR China. Fax: +86-311-87023626.
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Enhanced bone formation in rat critical-size tibia defect by a novel quercetin-containing alpha-calcium sulphate hemihydrate/nano-hydroxyapatite composite. Biomed Pharmacother 2021; 146:112570. [PMID: 34959114 DOI: 10.1016/j.biopha.2021.112570] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 12/13/2021] [Accepted: 12/19/2021] [Indexed: 11/22/2022] Open
Abstract
We developed an innovative method to include quercetin into alpha-calcium sulphate hemihydrate/nano-hydroxyapatite (α-CSH/n-HA), to prepare a novel quercetin-containing α-CSH/n-HA composite (Q-α-CSH/n-HA). The physicochemical properties, and ability of Q-α-CSH/n-HA to promote cell proliferation, migration, and osteogenic differentiation of bone marrow stem cells (BMSCs) in vitro were examined. Further, the potential of Q-α-CSH/n-HA to promote bone defect repair was studied using a Sprague-Dawley rat model of critical tibial defects. Imaging was conducted by radiography and micro-CT, and bone defect repairs were observed by histopathological staining. Addition of quercetin clearly increased the porosity of the degraded composite, which elevated the cell proliferation rate, migration ability, osteogenesis differentiation, and mineralisation of BMSCs. Further, quercetin-containing composite increased the expression levels of OSX, RUNX2, OCN, ALP, BMP-2, OPN, BSP, SMAD2, and TGF-β in BMSCs, while it downregulated TNF-α. X-ray and micro-CT imaging showed that the quercetin-containing composite significantly enhanced bone defect repair and new bone in formation. Haematoxylin and eosin, Goldner, and Safranin O staining also showed that quercetin significantly increased new bone generation and promoted composite degradation and absorption. Moreover, immunofluorescence assay revealed that quercetin significantly increased the number of RUNX2/OSX/OCN-positive cells. Overall, our data demonstrate that Q-α-CSH/n-HA has excellent biocompatibility, bone conductivity, and osteo-induction performance in vitro and mediates enhanced overall repair effects and bone reconstruction in vivo, indicating that it is a promising artificial bone graft to promote bone regeneration.
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20
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Physicochemical and biological properties of carboxymethyl chitosan zinc (CMCS-Zn)/α‑calcium sulfate hemihydrate (α-CSH) composites. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 131:112496. [PMID: 34857282 DOI: 10.1016/j.msec.2021.112496] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 12/30/2022]
Abstract
To improve the osteoinductivity, antibacterial activity, and clinical application of calcium sulfate hemihydrate (CSH), carboxymethyl chitosan zinc (CMCS-Zn) and α-CSH were prepared using different mass ratios. The setting time and injectability of the CMCS-Zn/α-CSH composite were increased with increasing CMCS-Zn content. After adding different amounts of CMCS-Zn to α-CSH, the fine lamellar structure of CMCS-Zn was found by scanning electron microscopy (SEM), which is evenly distributed in the matrix of α-CSH. With the increase of CMCS-Zn, the pores on the surface gradually increased. After mixing CMCS-Zn and α-CSH, no new phase was measured by X-ray diffraction (XRD) and Fourier transform (FTIR) spectroscopy. The degradation rate of CMCS-Zn/α-CSH decreased with increasing CMCS-Zn content, and the pH was stable during the degradation process. The release of Zn2+ increased with increasing CMCS-Zn content, while the release of Ca2+ decreased. Extracts of CMCS-Zn/α-CSH composites up-regulated the osteoinduction and migration of rat bone marrow stem cells. The antibacterial ability of CMCS-Zn/α-CSH was evaluated as a function of CMCS-Zn content. In the rat bone defect model, 5% CMCS-Zn/α-CSH group revealed a higher volume and density of trabeculae by micro-CT 8 weeks after the operation. Therefore, CMCS-Zn/α-CSH was demonstrated to be an adjustable, degradable, substitute biomaterial (with osteogenesis-promoting effects) for use in bone defects, which also has antibacterial activity that can suppress bone infection.
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21
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Conway JC, Oliver RA, Wang T, Wills DJ, Herbert J, Buckland T, Walsh WR, Gibson IR. The efficacy of a nanosynthetic bone graft substitute as a bone graft extender in rabbit posterolateral fusion. Spine J 2021; 21:1925-1937. [PMID: 34033931 DOI: 10.1016/j.spinee.2021.05.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/20/2021] [Accepted: 05/19/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Synthetic bone graft substitutes are commonly used in spinal fusion surgery. Preclinical data in a model of spinal fusion to support their efficacy is an important component in clinical adoption to understand how these materials provide a biological and mechanical role in spinal fusion. PURPOSE To evaluate the in vivo response of a nanosynthetic silicated calcium phosphate putty (OstP) combined with autograft compared to autograft alone or a collagen-biphasic calcium phosphate putty (MasP) combined with autograft in a rabbit spinal fusion model. STUDY DESIGN Efficacy of a nanosynthetic silicated calcium phosphate putty as an extender to autograft was studied in an experimental animal model of posterolateral spinal fusion at 6, 9, 12 and 26 weeks, compared to a predicate device. METHODS Skeletally mature female New Zealand White rabbits (70) underwent single level bilateral posterolateral intertransverse process lumbar fusion, using either autograft alone (AG), a nanosynthetic silicated calcium phosphate putty (OstP) combined with autograft (1:1), or a collagen-biphasic calcium phosphate putty (MasP) combined with autograft (1:1). Iliac crest autograft was harvested for each group, and a total of 2 cc of graft material was implanted in the posterolateral gutters per side. Fusion success was assessed at all time points by manual palpation, radiographic assessment, micro-CT and at 12 weeks only using non-destructive range of motion testing. Tissue response, bone formation and graft resorption were assessed by decalcified paraffin histology and by histomorphometry of PMMA embedded sections. RESULTS Assessment of fusion by manual palpation at the 12 week endpoint showed 7 out of 8 (87.5%) bilateral fusions in the OstP extender group, 4 out of 8 (50%) fusions in the MasP extender group, and 6 out of 8 (75%) fusions in the autograft alone group. Similar trends were observed with fusion scores of radiographic and micro-CT data. Histology showed a normal healing response in all groups, and increased bone formation in the OstP extender group at all timepoints compared to the MasP extender group. New bone formed directly on the OstP granule surface within the fusion mass while this was not a feature of the Collagen-Biphasic CaP material. After 26 weeks the OstP extender group exhibited 100% fusions (5 out of 5) by all measures, whereas the MasP extender group resulted in bilateral fusions in 3 out of 5 (60%), assessed by manual palpation, and fusion of only 20 and 0% by radiograph and micro-CT scoring, respectively. Histology at 26 weeks showed consistent bridging of bone between the transverse processes in the Ost P extender group, but this was not observed in the MasP extender group. CONCLUSIONS The nanosynthetic bone graft substituted studied here, used as an extender to autograft, showed a progression to fusion between 6 and 12 weeks that was similar to that observed with autograft alone, and showed excellent fusion outcomes, bone formation and graft resorption at 26 weeks. CLINICAL SIGNIFICANCE This preclinical study showed that the novel nanosynthetic silicated CaP putty, when combined with autograft, achieved equivalent fusion outcomes to autograft. The development of synthetic bone grafts that demonstrate efficacy in such models can eliminate the need for excessive autograft harvest and results from this preclinical study supports their effective use in spinal fusion surgery.
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Affiliation(s)
- Jordan C Conway
- Sirakoss Ltd., Polwarth Building, Foresterhill, Aberdeen, Scotland, AB25 2ZD, UK
| | - Rema A Oliver
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, UNSW Sydney, Level 1, Clinical Sciences Building, Gate 6, Avoca St, Randwick, Sydney, NSW 2031, Australia
| | - Tian Wang
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, UNSW Sydney, Level 1, Clinical Sciences Building, Gate 6, Avoca St, Randwick, Sydney, NSW 2031, Australia
| | - Daniel J Wills
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, UNSW Sydney, Level 1, Clinical Sciences Building, Gate 6, Avoca St, Randwick, Sydney, NSW 2031, Australia
| | - Joe Herbert
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, UNSW Sydney, Level 1, Clinical Sciences Building, Gate 6, Avoca St, Randwick, Sydney, NSW 2031, Australia
| | - Tom Buckland
- Sirakoss Ltd., Polwarth Building, Foresterhill, Aberdeen, Scotland, AB25 2ZD, UK
| | - William R Walsh
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, UNSW Sydney, Level 1, Clinical Sciences Building, Gate 6, Avoca St, Randwick, Sydney, NSW 2031, Australia
| | - Iain R Gibson
- Sirakoss Ltd., Polwarth Building, Foresterhill, Aberdeen, Scotland, AB25 2ZD, UK; Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, Scotland, AB25 2ZD, UK.
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22
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Medeiros Savi F, Mieszczanek P, Revert S, Wille ML, Bray LJ. A New Automated Histomorphometric MATLAB Algorithm for Immunohistochemistry Analysis Using Whole Slide Imaging. Tissue Eng Part C Methods 2021; 26:462-474. [PMID: 32729382 DOI: 10.1089/ten.tec.2020.0153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The use of animal models along with the employment of advanced and sophisticated stereological methods for assessing bone quality combined with the use of statistical methods to evaluate the effectiveness of bone therapies has made it possible to investigate the pathways that regulate bone responses to medical devices. Image analysis of histomorphometric measurements remains a time-consuming task, as the image analysis software currently available does not allow for automated image segmentation. Such a feature is usually obtained by machine learning and with software platforms that provide image-processing tools such as MATLAB. In this study, we introduce a new MATLAB algorithm to quantify immunohistochemically stained critical-sized bone defect samples and compare the results with the commonly available Aperio Image Scope Positive Pixel Count (PPC) algorithm. Bland and Altman analysis and Pearson correlation showed that the measurements acquired with the new MATLAB algorithm were in excellent agreement with the measurements obtained with the Aperio PPC algorithm, and no significant differences were found within the histomorphometric measurements. The ability to segment whole slide images, as well as defining the size and the number of regions of interest to be quantified, makes this MATLAB algorithm a potential histomorphometric tool for obtaining more objective, precise, and reproducible quantitative assessments of entire critical-sized bone defect image data sets in an efficient and manageable workflow.
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Affiliation(s)
- Flavia Medeiros Savi
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Pawel Mieszczanek
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Sophia Revert
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Marie-Luise Wille
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia.,ARC ITTC for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Laura Jane Bray
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia
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23
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Landeck JT, Walsh WR, Oliver RA, Wang T, Gordon MR, Ahn E, White CD. Temporal response of an injectable calcium phosphate material in a critical size defect. J Orthop Surg Res 2021; 16:496. [PMID: 34389027 PMCID: PMC8362253 DOI: 10.1186/s13018-021-02651-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/05/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Calcium phosphate-based bone graft substitutes are used to facilitate healing in bony defects caused by trauma or created during surgery. Here, we present an injectable calcium phosphate-based bone void filler that has been purposefully formulated with hyaluronic acid to offer a longer working time for ease of injection into bony defects that are difficult to access during minimally invasive surgery. METHODS The bone substitute material deliverability and physical properties were characterized, and in vivo response was evaluated in a critical size distal femur defect in skeletally mature rabbits to 26 weeks. The interface with the host bone, implant degradation, and resorption were assessed with time. RESULTS The calcium phosphate bone substitute material could be injected as a paste within the working time window of 7-18 min, and then self-cured at body temperature within 10 min. The material reached a maximum ultimate compressive strength of 8.20 ± 0.95 MPa, similar to trabecular bone. The material was found to be biocompatible and osteoconductive in vivo out to 26 weeks, with new bone formation and normal bone architecture observed at 6 weeks, as demonstrated by histological evaluation, microcomputed tomography, and radiographic evaluation. CONCLUSIONS These findings show that the material properties and performance are well suited for minimally invasive percutaneous delivery applications.
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Affiliation(s)
- Jacob T Landeck
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, MA, 01605, USA
- Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA, 01605, USA
| | - William R Walsh
- Surgical & Orthopaedic Research Laboratories (SORL), Prince of Wales Clinical School, Level 1 Clinical Sciences Building, Prince of Wales Hospital, UNSW Sydney, Sydney, Australia.
| | - Rema A Oliver
- Surgical & Orthopaedic Research Laboratories (SORL), Prince of Wales Clinical School, Level 1 Clinical Sciences Building, Prince of Wales Hospital, UNSW Sydney, Sydney, Australia
| | - Tian Wang
- Surgical & Orthopaedic Research Laboratories (SORL), Prince of Wales Clinical School, Level 1 Clinical Sciences Building, Prince of Wales Hospital, UNSW Sydney, Sydney, Australia
| | | | | | - Colin D White
- Vertex Pharmaceuticals, 50 Northern Ave, Boston, MA, 02210, USA
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24
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Picavet PP, Balligand M, Crigel MH, Antoine N, Claeys S. In vivo evaluation of deer antler trabecular bone as a reconstruction material for bone defects. Res Vet Sci 2021; 138:116-124. [PMID: 34129994 DOI: 10.1016/j.rvsc.2021.06.012] [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: 11/30/2020] [Revised: 04/05/2021] [Accepted: 06/09/2021] [Indexed: 11/30/2022]
Abstract
Availability of graft materials to fill up osseous defects has always been a concern in orthopaedic surgeries. Deer antler material is a primary bone structure that is easy to collect and could serve as a xenograft. This study examines the behaviour of red deer antler trabecular cylinders in critical size distal femoral epiphyseal defects in 11 rabbits, and evaluates the effect of the decellularization protocols. Two preparation regimes (A and B) were used, with and without lipids and proteins. Radiographs were taken immediately after surgery and after euthanasia 12 weeks post-implantation. Histological evaluation was performed on non-decalcified 10-μm sections with a van Gieson picro-fuchsin staining protocol. A region of interest was defined for each histological section, evaluating the inflammatory reaction, the fibrosis process, and the osteogenesis. Each histological section was microradiographed to evaluate bone contact, presence of synostosis, remodelling and ossification processes. All antler cylinders were successfully implanted. Final radiographic analysis demonstrated osteointegration of most implants at various stages. Light to moderate inflammation around the grafts was noted with only one case showing full encapsulation. A variable degree of intimacy between implant and host bone was evidenced, with bone remodelling and osteogenesis of various intensity being present in all implanted sites. No differences were found between group A and B. Removal of lipids and proteins in the grafts surprisingly did not seem to matter. Decellularization and sterilization protocols may be advocated. Although it presents several limitations, this study shows some promising results regarding antler trabecular bone osteointegration.
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Affiliation(s)
- Pierre P Picavet
- Department of Clinical Sciences, FARAH, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, Avenue de Cureghem 1 - B67, Liège, Belgium.
| | - Marc Balligand
- Department of Clinical Sciences, FARAH, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, Avenue de Cureghem 1 - B67, Liège, Belgium
| | | | - Nadine Antoine
- Department of Clinical Sciences, FARAH, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, Avenue de Cureghem 1 - B67, Liège, Belgium
| | - Stéphanie Claeys
- Department of Clinical Sciences, FARAH, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, Avenue de Cureghem 1 - B67, Liège, Belgium
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25
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Bonithon R, Kao AP, Fernández MP, Dunlop JN, Blunn GW, Witte F, Tozzi G. Multi-scale mechanical and morphological characterisation of sintered porous magnesium-based scaffolds for bone regeneration in critical-sized defects. Acta Biomater 2021; 127:338-352. [PMID: 33831571 DOI: 10.1016/j.actbio.2021.03.068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/11/2021] [Accepted: 03/31/2021] [Indexed: 12/19/2022]
Abstract
Magnesium (Mg) and its alloys are very promising degradable, osteoconductive and osteopromotive materials to be used as regenerative treatment for critical-sized bone defects. Under load-bearing conditions, Mg alloys must display sufficient morphological and mechanical resemblance to the native bone they are meant to replace to provide adequate support and enable initial bone bridging. In this study, unique highly open-porous Mg-based scaffolds were mechanically and morphologically characterised at different scales. In situ X-ray computed tomography (XCT) mechanics, digital volume correlation (DVC), electron microscopy and nanoindentation were combined to assess the influence of material properties on the apparent (macro) mechanics of the scaffold. The results showed that Mg exhibited a higher connected structure (38.4mm-3 and 6.2mm-3 for Mg and trabecular bone (Tb), respectively) and smaller spacing (245µm and 629µm for Mg and Tb, respectively) while keeping an overall appropriate porosity of 55% in the range of trabecular bone (30-80%). This fully connected and highly porous structure promoted lower local strain compared to the trabecular bone structure at material level (i.e. -22067 ± 8409µε and -40120 ± 18364µε at 6% compression for Mg and trabecular bone, respectively) and highly ductile mechanical behaviour at apparent level preventing premature scaffold failure. Furthermore, the Mg scaffolds exceeded the physiological strain of bone tissue generated in daily activities such as walking or running (500-2000µε) by one order of magnitude. The yield stress was also found to be close to trabecular bone (2.06MPa and 6.67MPa for Mg and Tb, respectively). Based on this evidence, the study highlights the overall biomechanical suitability of an innovative Mg-based scaffold design to be used as a treatment for bone critical-sized defects. STATEMENT OF SIGNIFICANCE: Bone regeneration remains a challenging field of research where different materials and solutions are investigated. Among the variety of treatments, biodegradable magnesium-based implants represent a very promising possibility. The novelty of this study is based on the characterisation of innovative magnesium-based implants whose structure and manufacturing have been optimised to enable the preservation of mechanical integrity and resemble bone microarchitecture. It is also based on a multi-scale approach by coupling high-resolution X-ray computed tomography (XCT), with in situ mechanics, digital volume correlation (DVC) as well as nano-indentation and electron-based microscopy imaging to define how degradable porous Mg-based implants fulfil morphological and mechanical requirements to be used as critical bone defects regeneration treatment.
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26
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Porous Biphasic Calcium Phosphate for Biomedical Application. JOURNAL OF BIOMIMETICS BIOMATERIALS AND BIOMEDICAL ENGINEERING 2021. [DOI: 10.4028/www.scientific.net/jbbbe.49.101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Excellent osteoconductivity and resorbability achieved when porous bioceramics have highsurface area that providing fast bone ingrowth. Porous samples were fabricated by using biphasic calcium phosphate BCP (achieved from HA heat treated at 850 oC) with 10 and 20 wt% of ovalbumin binder powder and mixture of carrot fibers and ovalbumin powders (1:1) then dried at 60oC and fired at 1300 oC. Structural, physical and mechanical properties of the prepared porous bioceramic were determined involved X-ray diffraction, Fourier transform infrared spectroscopy FTIR, apparent porosity, water absorption, apparent solid density and compressive strength. The results of X-ray and FTIR showed that the heat treatment of HA was succeeded in forming biphasic calcium phosphate. The apparent porosity values increased with increasing of the binder and carrot fibers content and the growths density of bacteria on bioceramics are less than natural bone. The effect of pathogenic bacteria (Pseudomonas & Staphylococcus) that cause pollution on porous calcium phosphate and natural bone (Albino mice) has been studied.
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27
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Lira RM, Sartoretto SC, da Silva Gouveia Pedrosa C, Calasans-Maia MD, Leite PE, Granjeiro JM. Is THP-1 viability affected by the crystallinity of nanostructured carbonated hydroxyapatites? J Biomed Mater Res A 2020; 109:1266-1274. [PMID: 33047463 DOI: 10.1002/jbm.a.37120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 10/04/2020] [Accepted: 10/09/2020] [Indexed: 11/06/2022]
Abstract
In daily clinical practice, there is a notable variety of synthetic bone substitute, with various resorption rates, different chemical and structural characteristics that influence on bone regeneration and are not suitable for every clinical use. New biomaterials based on nanotechnology have been developed to be bioabsorbable as new bone is formed. This study intends to evaluate THP-1 cell viability when exposed to extracts of unsintered nanostructured carbonated hydroxyapatite (cHA) microspheres processed at 5 and 37°C compared to sintered hydroxyapatite processed at 90°C. cHA shows, in previous studies, biocompatibility, and better bioabsorption rates, consequently, improve the deposition of new bone and tissue repair. The results demonstrated that the tested biomaterials did not activate inflammatory role through THP-1 cells and did not affect activated macrophages independently of their crystallinities, suggesting their safety and biocompatibility. These results are of fundamental importance for the advancement of research on smart materials, especially in what controls the effect of nanostructured cHA microspheres in the biological environment, seems to be a promising biomaterial in clinical application on regenerative medicine.
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Affiliation(s)
- Renata Moraes Lira
- Graduate Program in Dentistry, Fluminense Federal University, Niterói, Brazil
| | - Suelen Cristina Sartoretto
- Graduate Program in Dentistry, Fluminense Federal University, Niterói, Brazil.,Graduate Program in Dentistry, Veiga de Almeida University, Rio de Janeiro, Brazil.,Oral Surgery Department, Iguaçu University, Nova Iguaçu, Brazil
| | | | | | - Paulo Emílio Leite
- Laboratory of Ultrastructure and Cellular Biology Hertha Meyer, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - José Mauro Granjeiro
- Bioengineering Laboratory, National Institute of Metrology, Quality and Technology, Duque de Caxias, Brazil.,School of Dentistry, Fluminense Federal University, Niterói, Brazil
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28
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Allan B, Ruan R, Landao-Bassonga E, Gillman N, Wang T, Gao J, Ruan Y, Xu Y, Lee C, Goonewardene M, Zheng M. Collagen Membrane for Guided Bone Regeneration in Dental and Orthopedic Applications. Tissue Eng Part A 2020; 27:372-381. [PMID: 32741266 DOI: 10.1089/ten.tea.2020.0140] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Treatment of cortical bone defects is a clinical challenge. Guided bone regeneration (GBR), commonly used in oral and maxillofacial dental surgery, may show promise for orthopedic applications in repair of cortical bone defects. However, a limitation in the use of GBR for cortical bone defects is the lack of an ideal scaffold that provides sufficient mechanical support to bridge the cortical bone with minimal interference in the repair process. We have developed a new collagen membrane, CelGro™, for use in GBR. We report the material characterization of CelGro and evaluate the performance of CelGro in translational preclinical and clinical studies. The results show CelGro has a bilayer structure of different fiber alignment and is composed almost exclusively of type I collagen. CelGro was found to be completely acellular and free from xenoantigen, α-gal (galactose-alpha-1,3-galactose). In the preclinical study of a rabbit cortical bone defect model, CelGro demonstrated enhanced bone-remodeling activity and cortical bone healing. Microcomputed tomography evaluation showed early bony bridging over the defect area 30 days postoperatively, and nearly complete restoration of mature cortical bone at the bone defect site 60 days postoperatively. Histological analysis 60 days after surgery further confirmed that CelGro enables bridging of the cortical bone defect by induction of newly formed cortical bone. Compared to a commercially available collagen membrane, Bio-Gide®, CelGro showed much better cortical alignment and reduced porosity at the defect interface. As selection of orthopedic patients with cortical bone defects is complex, we conducted a clinical study evaluating the performance of CelGro in guided bone regeneration around dental implants. CelGro was used in GBR procedures in a total of 16 implants placed in 10 participants. Cone-beam computed tomography images show significantly increased bone formation both horizontally and vertically, which provides sufficient support to stabilize implants within 4 months. Together, the findings of our study demonstrate that CelGro is an ideal membrane for GBR not only in oral and maxillofacial reconstructive surgery but also in orthopedic applications (Clinical Trial ID ACTRN12615000027516).
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Affiliation(s)
- Brent Allan
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia.,Oral and Maxillofacial Department, St John of God Subiaco Hospital, Subiaco, Western Australia, Australia.,Orthodontics, Dental School, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Rui Ruan
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Euphemie Landao-Bassonga
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Nicholas Gillman
- Griffith University School of Medicine, Gold Coast, Queensland, Australia
| | - Tao Wang
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Junjie Gao
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia.,Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Yonghua Ruan
- Department of Pathology, Kunming Medical University, Kunming, China
| | - Yuan Xu
- Medical Imaging Center, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Clair Lee
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Mithran Goonewardene
- Orthodontics, Dental School, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Minghao Zheng
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia.,Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
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29
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Oliver RA, Lovric V, Christou C, Walsh WR. Comparative osteoconductivity of bone void fillers with antibiotics in a critical size bone defect model. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2020; 31:80. [PMID: 32840717 PMCID: PMC7447650 DOI: 10.1007/s10856-020-06418-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 07/24/2020] [Indexed: 06/11/2023]
Abstract
The study aimed to evaluate the comparative osteoconductivity of three commercially available bone void fillers containing gentamicin with respect to new bone, growth, host tissue response and resorption of the implant material. Defects were created in the cancellous bone of the distal femur and proximal tibia of 12-skeletally mature sheep and filled with three commercially available bone void fillers containing gentamicin (Stimulan-G, Cerament-G, Herafill-G). Peripheral blood was taken pre-operatively and at the time of implantation, as well as at intermittent timepoints following surgery to determine systemic gentamicin levels (5-,15- and 30- minutes, 1, 2, 3, 6, 12, 24, 48- and 72-hours, 3-, 6- and 12-weeks). Decalcified, embedded samples were stained with haematoxylin and eosin (H&E) and used to assess the host tissue response and the formation of new bone in the presence of test implant materials. No adverse reactions were noted at harvest at any time points for any cancellous implantation sites with the various implant materials. Comparative microCT analysis of the Stimulan-G, Cerament-G and Herafill-G test materials revealed a similar increase in bone surface area and volume between animals implanted with Stimulan-G or Cerament-G test materials. Animals implanted with Herafill-G test materials demonstrated the lowest increases in bone volume and surface area of the test materials tested, at levels similar to the negative control sites. By 12-weeks, Stimulan-G defects were completely closed with mature bone and bone marrow whilst the Cerament-G material was still present after 12 weeks by histological examination. In conclusion, this study demonstrated differences in the bone regenerative capacity of a range of bone void fillers in an in vivo setting.
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Affiliation(s)
- Rema A Oliver
- Surgical and Orthopaedic Research Laboratories, UNSW Sydney, Prince of Wales Clinical School, Prince of Wales Hospital, Level 1 Clinical Sciences Building, Randwick, NSW, Australia.
| | - Vedran Lovric
- Surgical and Orthopaedic Research Laboratories, UNSW Sydney, Prince of Wales Clinical School, Prince of Wales Hospital, Level 1 Clinical Sciences Building, Randwick, NSW, Australia
| | - Chris Christou
- Surgical and Orthopaedic Research Laboratories, UNSW Sydney, Prince of Wales Clinical School, Prince of Wales Hospital, Level 1 Clinical Sciences Building, Randwick, NSW, Australia
| | - William R Walsh
- Surgical and Orthopaedic Research Laboratories, UNSW Sydney, Prince of Wales Clinical School, Prince of Wales Hospital, Level 1 Clinical Sciences Building, Randwick, NSW, Australia
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Abstract
STUDY DESIGN This study was a multi-endpoint analysis of bone graft substitutes implanted as a standalone graft in a clinically relevant Ovine model of instrumented posterolateral spinal fusion (PLF). OBJECTIVE The objective of this study was to obtain high-quality evidence on the efficacy of commercial bone graft substitutes compared with autograft in instrumented PLF using a state-of-the-art model with a complete range of assessment techniques. SUMMARY OF BACKGROUND DATA Preclinical and clinical data on the quality of spinal fusions obtained with bone graft substitutes are often limited. Calcium phosphates with submicron topography have shown promising results in PLF, as these are able to induce bone formation in tissues distant from the host bone, which facilitates bony union. METHODS Nine female, skeletally mature sheep (4-5 y) underwent posterior pedicle screw/rods instrumented PLF at L2-L3 and L4-L5 using the following bone graft materials as a standalone graft per spinal segment: (1) biphasic calcium phosphate with submicron topography (BCP<µm), (2) 45S5 Bioglass (BG), and (3) collagen-β-tricalcium phosphate with a 45S5 Bioglass adjunct (TCP/BG). Autograft bone (AB) was used as a positive control treatment. Twelve weeks after implantation, the spinal segments were evaluated by fusion assessment (manual palpation, x-ray, micro-computed tomography, and histology), fusion mass volume quantification (micro-computed tomography), range of motion (ROM) testing, histologic evaluation, and histomorphometry. RESULTS Fusion assessment revealed equivalence between AB and BCP<µm by all fusion assessment methods, whereas BG and TCP/BG led to significantly inferior results. Fusion mass volume was highest for BCP<µm, followed by AB, BG, and TCP/BG. ROM testing determined equivalence for spinal levels treated with AB and BCP<µm, while BG and TCP/BG exhibited higher ROM. Histologic evaluation revealed substantial bone formation in the intertransverse regions for AB and BCP<µm, whereas BG and TCP/BG grafts contained fibrous tissue and minimal bone formation. Histologic observations were supported by the histomorphometry data. CONCLUSIONS This study reveals clear differences in efficacy between commercially available bone graft substitutes, emphasizing the importance of clinically relevant animal models with multiendpoint analyses for the evaluation of bone graft materials. The results corroborate the efficacy of calcium phosphate with submicron topography, as this was the only material that showed equivalent performance to autograft in achieving spinal fusion.
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Walsh WR, Pelletier MH, Bertollo N, Lovric V, Wang T, Morberg P, Parr WCH, Bergadano D. Bone ongrowth and mechanical fixation of implants in cortical and cancellous bone. J Orthop Surg Res 2020; 15:177. [PMID: 32408885 PMCID: PMC7227327 DOI: 10.1186/s13018-020-01696-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 05/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND What is the right surface for an implant to achieve biological fixation? Surface technologies can play important roles in encouraging interactions between the implant surface and the host bone to achieve osseointegration. Preclinical animal models provide important insight into in vivo performance related to bone ongrowth and implant fixation. METHODS A large animal model was used to compare the in vivo response of HA and plasma-sprayed titanium coatings in a well-reported adult ovine model to evaluate bone ongrowth in terms of mechanical properties in cortical sites, and histology and histomorphometry in cortical and cancellous sites at 4 and 12 weeks. RESULTS Titanium plasma-sprayed surfaces outperformed the HA-coated samples in push-out testing in cortical sites while both surfaces supported new bone ongrowth and remodeling in cortical and cancellous sites. CONCLUSIONS While both HA and Ti plasma provided an osteoconductive surface for bone ongrowth, the Ti plasma provided a more robust bone-implant interface that ideally would be required for load transfer and implant stability in the longer term.
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Affiliation(s)
- William Robert Walsh
- Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales Clinical School, UNSW Sydney, Kensington, Australia.
| | - Matthew Henry Pelletier
- Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales Clinical School, UNSW Sydney, Kensington, Australia
| | - Nicky Bertollo
- Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales Clinical School, UNSW Sydney, Kensington, Australia
| | - Vedran Lovric
- Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales Clinical School, UNSW Sydney, Kensington, Australia
| | - Tian Wang
- Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales Clinical School, UNSW Sydney, Kensington, Australia
| | - Per Morberg
- Department of Surgical and Perioperative Sciences, Umea University, Umea, Sweden
| | - William Chase Harington Parr
- Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales Clinical School, UNSW Sydney, Kensington, Australia
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Pereira HF, Cengiz IF, Silva FS, Reis RL, Oliveira JM. Scaffolds and coatings for bone regeneration. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2020; 31:27. [PMID: 32124052 DOI: 10.1007/s10856-020-06364-y] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 02/13/2020] [Indexed: 05/28/2023]
Abstract
Bone tissue has an astonishing self-healing capacity yet only for non-critical size defects (<6 mm) and clinical intervention is needed for critical-size defects and beyond that along with non-union bone fractures and bone defects larger than critical size represent a major healthcare problem. Autografts are, still, being used as preferred to treat large bone defects. Mostly, due to the presence of living differentiated and progenitor cells, its osteogenic, osteoinductive and osteoconductive properties that allow osteogenesis, vascularization, and provide structural support. Bone tissue engineering strategies have been proposed to overcome the limited supply of grafts. Complete and successful bone regeneration can be influenced by several factors namely: the age of the patient, health, gender and is expected that the ideal scaffold for bone regeneration combines factors such as bioactivity and osteoinductivity. The commercially available products have as their main function the replacement of bone. Moreover, scaffolds still present limitations including poor osteointegration and limited vascularization. The introduction of pores in scaffolds are being used to promote the osteointegration as it allows cell and vessel infiltration. Moreover, combinations with growth factors or coatings have been explored as they can improve the osteoconductive and osteoinductive properties of the scaffold. This review focuses on the bone defects treatments and on the research of scaffolds for bone regeneration. Moreover, it summarizes the latest progress in the development of coatings used in bone tissue engineering. Despite the interesting advances which include the development of hybrid scaffolds, there are still important challenges that need to be addressed in order to fasten translation of scaffolds into the clinical scenario. Finally, we must reflect on the main challenges for bone tissue regeneration. There is a need to achieve a proper mechanical properties to bear the load of movements; have a scaffolds with a structure that fit the bone anatomy.
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Affiliation(s)
- Helena Filipa Pereira
- 3B's Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal.
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.
- Center for Micro-Electro Mechanical Systems, University of Minho, Azurém Campus, 4800-058, Guimarães, Portugal.
| | - Ibrahim Fatih Cengiz
- 3B's Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
- The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, AvePark, Barco, 4805-017, Guimarães, Portugal
| | - Filipe Samuel Silva
- Center for Micro-Electro Mechanical Systems, University of Minho, Azurém Campus, 4800-058, Guimarães, Portugal
| | - Rui Luís Reis
- 3B's Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
- The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, AvePark, Barco, 4805-017, Guimarães, Portugal
| | - Joaquim Miguel Oliveira
- 3B's Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
- The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, AvePark, Barco, 4805-017, Guimarães, Portugal
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FERNÁNDEZ MPEÑA, WITTE F, TOZZI G. Applications of X‐ray computed tomography for the evaluation of biomaterial‐mediated bone regeneration in critical‐sized defects. J Microsc 2020; 277:179-196. [DOI: 10.1111/jmi.12844] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 10/06/2019] [Accepted: 11/04/2019] [Indexed: 12/16/2022]
Affiliation(s)
- M. PEÑA FERNÁNDEZ
- Zeiss Global Centre, School of Mechanical and Design EngineeringUniversity of Portsmouth Portsmouth UK
| | - F. WITTE
- Biotrics Bioimplants GmbH Berlin Germany
| | - G. TOZZI
- Zeiss Global Centre, School of Mechanical and Design EngineeringUniversity of Portsmouth Portsmouth UK
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Busch A, Wegner A, Haversath M, Jäger M. Bone Substitutes in Orthopaedic Surgery: Current Status and Future Perspectives. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2020; 159:304-313. [PMID: 32023626 DOI: 10.1055/a-1073-8473] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Bone replacement materials have been successfully supplied for a long time. But there are cases, especially in critical sized bone defects, in which the therapy is not sufficient. Nowadays, there are multiple bone substitutes available. Autologous bone grafts remain the "gold standard" in bone regeneration. Yet, donor-site morbidity and the available amount of sufficient material are limitations for autologous bone grafting. This study aimed to provide information about the current status in research regarding bone substitutes. We report on the advantages and drawbacks of several bone substitutes. At the end, we discuss the current developments of combining ceramic substitutes with osteoinductive substances.
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Affiliation(s)
- André Busch
- Department of Orthopaedics, Trauma and Reconstructive Surgery, Marienhospital Mülheim an der Ruhr, Chair of Orthopaedics and Trauma Surgery, University of Duisburg-Essen, Germany
| | - Alexander Wegner
- Department of Orthopaedics, Trauma and Reconstructive Surgery, Marienhospital Mülheim an der Ruhr, Chair of Orthopaedics and Trauma Surgery, University of Duisburg-Essen, Germany
| | - Marcel Haversath
- Department of Orthopaedics, Trauma and Reconstructive Surgery, Marienhospital Mülheim an der Ruhr, Chair of Orthopaedics and Trauma Surgery, University of Duisburg-Essen, Germany
| | - Marcus Jäger
- Department of Orthopaedics, Trauma and Reconstructive Surgery, Marienhospital Mülheim an der Ruhr, Chair of Orthopaedics and Trauma Surgery, University of Duisburg-Essen, Germany
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35
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Peña Fernández M, Black C, Dawson J, Gibbs D, Kanczler J, Oreffo ROC, Tozzi G. Exploratory Full-Field Strain Analysis of Regenerated Bone Tissue from Osteoinductive Biomaterials. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E168. [PMID: 31906343 PMCID: PMC6981952 DOI: 10.3390/ma13010168] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/02/2019] [Accepted: 12/28/2019] [Indexed: 12/25/2022]
Abstract
Biomaterials for bone regeneration are constantly under development, and their application in critical-sized defects represents a promising alternative to bone grafting techniques. However, the ability of all these materials to produce bone mechanically comparable with the native tissue remains unclear. This study aims to explore the full-field strain evolution in newly formed bone tissue produced in vivo by different osteoinductive strategies, including delivery systems for BMP-2 release. In situ high-resolution X-ray micro-computed tomography (microCT) and digital volume correlation (DVC) were used to qualitatively assess the micromechanics of regenerated bone tissue. Local strain in the tissue was evaluated in relation to the different bone morphometry and mineralization for specimens (n = 2 p/treatment) retrieved at a single time point (10 weeks in vivo). Results indicated a variety of load-transfer ability for the different treatments, highlighting the mechanical adaptation of bone structure in the early stages of bone healing. Although exploratory due to the limited sample size, the findings and analysis reported herein suggest how the combination of microCT and DVC can provide enhanced understanding of the micromechanics of newly formed bone produced in vivo, with the potential to inform further development of novel bone regeneration approaches.
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Affiliation(s)
- Marta Peña Fernández
- School of Mechanical and Design Engineering, University of Portsmouth, Portsmouth PO1 3DJ, UK;
| | - Cameron Black
- Bone & Joint Research Group, Centre for Human Development Stem Cells and Regeneration, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (C.B.); (J.D.); (D.G.); (J.K.); (R.O.C.O.)
| | - Jon Dawson
- Bone & Joint Research Group, Centre for Human Development Stem Cells and Regeneration, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (C.B.); (J.D.); (D.G.); (J.K.); (R.O.C.O.)
| | - David Gibbs
- Bone & Joint Research Group, Centre for Human Development Stem Cells and Regeneration, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (C.B.); (J.D.); (D.G.); (J.K.); (R.O.C.O.)
- School of Maritime Science and Engineering, Solent University, Southampton SO14 0YN, UK
| | - Janos Kanczler
- Bone & Joint Research Group, Centre for Human Development Stem Cells and Regeneration, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (C.B.); (J.D.); (D.G.); (J.K.); (R.O.C.O.)
| | - Richard O. C. Oreffo
- Bone & Joint Research Group, Centre for Human Development Stem Cells and Regeneration, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (C.B.); (J.D.); (D.G.); (J.K.); (R.O.C.O.)
| | - Gianluca Tozzi
- School of Mechanical and Design Engineering, University of Portsmouth, Portsmouth PO1 3DJ, UK;
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Wang D, Gilbert JR, Zhang X, Zhao B, Ker DFE, Cooper GM. Calvarial Versus Long Bone: Implications for Tailoring Skeletal Tissue Engineering. TISSUE ENGINEERING PART B-REVIEWS 2019; 26:46-63. [PMID: 31588853 DOI: 10.1089/ten.teb.2018.0353] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Tissue-engineered graft substitutes have shown great potential to treat large bone defects. While we usually assume that therapeutic approaches developed for appendicular bone healing could be similarly translated for application in craniofacial reconstruction and vice versa, this is not necessarily accurate. In addition to those more well-known healing-associated factors, such as age, lifestyle (e.g., nutrition and smoking), preexisting disease (e.g., diabetes), medication, and poor blood supply, the developmental origins and surrounding tissue of the wound sites can largely affect the fracture healing outcome as well as designed treatments. Therefore, the strategies developed for long bone fracture repair might not be suitable or directly applicable to skull bone repair. In this review, we discuss aspects of development, healing process, structure, and tissue engineering considerations between calvarial and long bones to assist in designing the tailored bone repair strategies. Impact Statement We summarized, in this review, the existing body of knowledge between long bone and calvarial bone with regard to their development and healing, tissue structure, and consideration of current tissue engineering strategies. By highlighting their similarities and differences, we propose that tailored tissue engineering strategies, such as scaffold features, growth factor usage, and the source of cells for tissue or region-specific bone repair, are necessary to ensure an optimized healing outcome.
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Affiliation(s)
- Dan Wang
- Department of Stomatology, Tenth People's Hospital of Tongji University, Shanghai, China.,Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong, China.,School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - James R Gilbert
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.,McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Xu Zhang
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong, China.,School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Bingkun Zhao
- Department of Stomatology, Tenth People's Hospital of Tongji University, Shanghai, China.,Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong, China.,School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Dai Fei Elmer Ker
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong, China.,School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Gregory M Cooper
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania
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37
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Current and Future Concepts for the Treatment of Impaired Fracture Healing. Int J Mol Sci 2019; 20:ijms20225805. [PMID: 31752267 PMCID: PMC6888215 DOI: 10.3390/ijms20225805] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/15/2019] [Accepted: 11/15/2019] [Indexed: 02/06/2023] Open
Abstract
Bone regeneration represents a complex process, of which basic biologic principles have been evolutionarily conserved over a broad range of different species. Bone represents one of few tissues that can heal without forming a fibrous scar and, as such, resembles a unique form of tissue regeneration. Despite a tremendous improvement in surgical techniques in the past decades, impaired bone regeneration including non-unions still affect a significant number of patients with fractures. As impaired bone regeneration is associated with high socio-economic implications, it is an essential clinical need to gain a full understanding of the pathophysiology and identify novel treatment approaches. This review focuses on the clinical implications of impaired bone regeneration, including currently available treatment options. Moreover, recent advances in the understanding of fracture healing are discussed, which have resulted in the identification and development of novel therapeutic approaches for affected patients.
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38
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Tebyanian H, Norahan MH, Eyni H, Movahedin M, Mortazavi SJ, Karami A, Nourani MR, Baheiraei N. Effects of collagen/β-tricalcium phosphate bone graft to regenerate bone in critically sized rabbit calvarial defects. J Appl Biomater Funct Mater 2019; 17:2280800018820490. [PMID: 30832532 DOI: 10.1177/2280800018820490] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Bone defects remain a significant health issue and a major cause of morbidity in elderly patients. Composites based on collagen/calcium phosphate have been widely used for bone repair in clinical applications, owing to their comparability to bone extracellular matrix. This study aimed to evaluate the effects of a scaffold of collagen/calcium phosphate (COL/β-TCP) on bone formation to assess its potential use as a bone substitute to repair bone defects. Bilateral full-thickness critically sized calvarial defects (8 mm in diameter) were created in New Zealand white rabbits and treated with COL/β-TCP or COL scaffolds. One defect was also left unfilled as a control. Bone regeneration was assessed through histological evaluation using hematoxylin and eosin and Masson's trichrome staining after 4 and 8 weeks. Alizarin Red staining was also utilized to observe the mineralization process. Our findings indicated that COL/β-TCP implantation could better enhance bone regeneration than COL and exhibited both new bone growth and scaffold material degradation.
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Affiliation(s)
- Hamid Tebyanian
- 1 Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Hossein Eyni
- 3 Department of Anatomical Science, faculty of medical sciences, Tarbiat Modares University, Tehran, Iran
| | - Mansoureh Movahedin
- 3 Department of Anatomical Science, faculty of medical sciences, Tarbiat Modares University, Tehran, Iran
| | - Sm Javad Mortazavi
- 4 Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Karami
- 1 Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Nourani
- 5 Nanobiotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Nafiseh Baheiraei
- 6 Tissue Engineering & Applied Cell Sciences Division, Department of hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Peña Fernández M, Dall’Ara E, Bodey AJ, Parwani R, Barber AH, Blunn GW, Tozzi G. Full-Field Strain Analysis of Bone–Biomaterial Systems Produced by the Implantation of Osteoregenerative Biomaterials in an Ovine Model. ACS Biomater Sci Eng 2019; 5:2543-2554. [DOI: 10.1021/acsbiomaterials.8b01044] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Marta Peña Fernández
- Zeiss Global Centre, School of Mechanical and Design Engineering, University of Portsmouth, Anglesea Building, Anglesea Road, Portsmouth, PO1 3DJ, U.K
| | - Enrico Dall’Ara
- Department of Oncology and Metabolism and INSIGNEO Institute for in silico Medicine, University of Sheffield, The Pam Liversidge Building, Sir Robert Hadfield Building, Mappin Street, Sheffield, S1 3JD, U.K
| | - Andrew J. Bodey
- Diamond Light Source, Diamond House, Harwell Science and Innovation Campus, Fermi Avenue, Didcot, OX11 0DE, U.K
| | - Rachna Parwani
- Zeiss Global Centre, School of Mechanical and Design Engineering, University of Portsmouth, Anglesea Building, Anglesea Road, Portsmouth, PO1 3DJ, U.K
| | - Asa H. Barber
- Zeiss Global Centre, School of Mechanical and Design Engineering, University of Portsmouth, Anglesea Building, Anglesea Road, Portsmouth, PO1 3DJ, U.K
- School of Engineering, London South Bank University, 103 Borough Road, London, SE1 0AA, U.K
| | - Gordon W. Blunn
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, St. Michael’s Building, White Swan Road, Portsmouth, PO1 2DT, U.K
| | - Gianluca Tozzi
- Zeiss Global Centre, School of Mechanical and Design Engineering, University of Portsmouth, Anglesea Building, Anglesea Road, Portsmouth, PO1 3DJ, U.K
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40
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Pettian MS, Plepis AMDG, Martins VDCA, dos Santos GR, Pinto CAL, Galdeano EA, Calegari ARA, de Moraes CA, da Cunha MR. Use of an anionic collagen matrix made from bovine intestinal serosa for in vivo repair of cranial defects. PLoS One 2018; 13:e0197806. [PMID: 30001321 PMCID: PMC6042682 DOI: 10.1371/journal.pone.0197806] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 05/09/2018] [Indexed: 12/15/2022] Open
Abstract
Polymeric biomaterials composed of extracellular matrix components possess osteoconductive capacity that is essential for bone healing. The presence of collagen and the ability to undergo physicochemical modifications render these materials a suitable alternative in bone regenerative therapies. The objective of this study was to evaluate the osteogenic capacity of collagen-based matrices (native and anionic after alkaline hydrolysis) made from bovine intestinal serosa (MBIS). Twenty-five animals underwent surgery to create a cranial defect to be filled with native and anionic collagen matrixes, mmineralized and non mineralized. The animals were killed painlessly 6 weeks after surgery and samples of the wound area were submitted to routine histology and morphometric analysis. In the surgical area there was new bone formation projecting from the margins to the center of the defect. More marked bone neoformation occurred in the anionic matrices groups in such a way that permitted union of the opposite margins of the bone defect. The newly formed bone matrix exhibited good optical density of type I collagen fibers. Immunoexpression of osteocalcin by osteocytes was observed in the newly formed bone. Morphometric analysis showed a greater bone volume in the groups receiving the anionic matrices compared to the native membranes. Mineralization of the biomaterial did not increase its osteoregenerative capacity. In conclusion, the anionic matrix exhibits osteoregenerative capacity and is suitable for bone reconstruction therapies.
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Affiliation(s)
- Mariane Silva Pettian
- Department of Morphology and Pathology, Faculty of Medicine of Jundiaí, São Paulo, Brazil, Jundiaí –SP, Brazil
| | - Ana Maria de Guzzi Plepis
- Interunit Postgraduate Program in Bioengineering, University of São Paulo, USP, São Carlos-SP, Brazil
- Institute of Chemistry of São Carlos, University of São Paulo, USP, São Carlos-SP, Brazil
| | | | - Geovane Ribeiro dos Santos
- Department of Morphology and Pathology, Faculty of Medicine of Jundiaí, São Paulo, Brazil, Jundiaí –SP, Brazil
| | - Clovis Antônio Lopes Pinto
- Department of Morphology and Pathology, Faculty of Medicine of Jundiaí, São Paulo, Brazil, Jundiaí –SP, Brazil
- Department of Anatomical Pathology, A.C. Camargo Cancer Center, São Paulo, SP, Brazil
| | - Ewerton Alexandre Galdeano
- Department of Morphology and Pathology, Faculty of Medicine of Jundiaí, São Paulo, Brazil, Jundiaí –SP, Brazil
| | | | - Carlos Alberto de Moraes
- Department of Morphology and Pathology, Faculty of Medicine of Jundiaí, São Paulo, Brazil, Jundiaí –SP, Brazil
| | - Marcelo Rodrigues da Cunha
- Department of Morphology and Pathology, Faculty of Medicine of Jundiaí, São Paulo, Brazil, Jundiaí –SP, Brazil
- Interunit Postgraduate Program in Bioengineering, University of São Paulo, USP, São Carlos-SP, Brazil
- * E-mail:
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Walsh WR, Pelletier MH, Christou C, He J, Vizesi F, Boden SD. The in vivo response to a novel Ti coating compared with polyether ether ketone: evaluation of the periphery and inner surfaces of an implant. Spine J 2018; 18:1231-1240. [PMID: 29496625 DOI: 10.1016/j.spinee.2018.02.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 01/22/2018] [Accepted: 02/13/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Increasing bone ongrowth and ingrowth of polyether ether ketone (PEEK) interbody fusion devices has the potential to improve clinical outcomes. PURPOSE This study evaluated the in vivo response of promoting new bone growth and bone apposition with NanoMetalene (NM) compared with PEEK alone in a cancellous implantation site with an empty aperture. STUDY DESIGN This is a randomized control animal study. METHODS Implants and funding for this study were provided by SeaSpine (60,000 USD). Cylindrical dowels with two apertures were prepared as PEEK with a sub-micron layer of the titanium (NM). The titanium coating was applied over the entire implant (Group 1) or just the apertures (Group 2). Polyether ether ketone implants with no coating served as controls (Group 3). Implants were placed in the cancellous bone of the distal femur or proximal tibia with no graft material placed in the apertures in eight adult sheep. Bone ongrowth to the surface of the implant and ingrowth into the apertures was assessed at 4 and 8 weeks after surgery with micro-computed tomography (CT) and undecalcified histology. RESULTS The apertures in the implants were notably empty in the PEEK group at 4 and 8 weeks. In contrast, new bone formation into the apertures was found in samples coated with NM even though no graft material was placed into the defect. The bone growing into the aperture tracked along the titanium layer. Apertures with the titanium coating demonstrated significantly more bone by micro-CT qualitative grading compared with PEEK with average bone coverage scores of Group 1 (NM) 1.62±0.89, Group 2 (NM apertures only) 1.62±0.77, and Group 3 (PEEK) 0.43±0.51, respectively, at 4 weeks (p<.01) and Group 1 (NM) 1.79±1.19, Group 2 (NM apertures only) 1.98±1.18, and Group 3 (PEEK) 0.69±0.87, respectively, at 8 weeks (p<.05). The amount of bone in the apertures (ingrowth) quantified using the volumetric data from the micro-CT supported an overall increase in bone volume inside the apertures with the titanium coating compared with PEEK. Histology showed newly formed woven bone tracked along the surface of the titanium in the apertures. The PEEK interface presented the typical nonreactive fibrous tissue inside the apertures at 4 weeks and some focal contact with bone on the outside at 4 weeks and 8 weeks. CONCLUSIONS Micro-CT and histology demonstrated bone ongrowth to the surfaces coated with NM where the newly formed bone tracked along the thin titanium-coated surfaces. Polyether ether ketone surfaces presented the nonreactive fibrous tissue at the interface as previously reported in preclinical scenarios.
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Affiliation(s)
- William Robert Walsh
- Surgical & Orthopaedic Research Laboratories, Prince of Wales Clinical School - The University of New South Wales, Avoca St, Randwick, Sydney, NSW 2031, Australia.
| | - Matthew H Pelletier
- Surgical & Orthopaedic Research Laboratories, Prince of Wales Clinical School - The University of New South Wales, Avoca St, Randwick, Sydney, NSW 2031, Australia
| | - Chris Christou
- Surgical & Orthopaedic Research Laboratories, Prince of Wales Clinical School - The University of New South Wales, Avoca St, Randwick, Sydney, NSW 2031, Australia
| | - Jiawei He
- SeaSpine, 5770 Armada Dr, Carlsbad, CA 92009, USA
| | - Frank Vizesi
- SeaSpine, 5770 Armada Dr, Carlsbad, CA 92009, USA
| | - Scott D Boden
- Emory Orthopaedics & Spine Center, Emory University, 59 Executive Park South, Suite 3000, Atlanta, GA 30329, USA
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Taz M, Bae SH, Jung HI, Cho HD, Lee BT. Bone regeneration strategy by different sized multichanneled biphasic calcium phosphate granules: In vivo evaluation in rabbit model. J Biomater Appl 2018; 32:1406-1420. [DOI: 10.1177/0885328218768605] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A variety of synthetic materials are currently in use as bone substitutes, among them a new calcium phosphate-based multichannel, cylindrical, granular bone substitute that is showing satisfactory biocompatibility and osteoconductivity in clinical applications. These cylindrical granules differ in their mechanical and morphological characteristics such as size, diameter, surface area, pore size, and porosity. The aim of this study is to investigate whether the sizes of these synthetic granules and the resultant inter-granular spaces formed by their filling critical-sized bone defects affect new bone formation characteristics and to determine the best formulations from these individual types by combining the granules in different proportions to optimize the bone tissue regeneration. We evaluated two types of multichanneled cylindrical granules, 1 mm and 3 mm in diameter, combined the granules in two different proportions (wt%), and compared their different mechanical, morphological, and in vitro and in vivo biocompatibility characteristics. We assessed in vitro biocompatibility and cytotoxicity using MC3T3-E1 osteoblast-like cells using MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay and confocal imaging. In vivo investigation in a rabbit model indicated that all four samples formed significantly better bone than the control after four weeks and eight weeks of implantation. Micro-computed tomography analysis showed more bone formation by the 1 mm cylindrical granules with 160 ± 10 µm channeled pore and 50% porosity than the other three samples ( p<.05), which we confirmed by histological analysis.
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Affiliation(s)
- Mirana Taz
- Department of Regenerative Medicine, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Sang Ho Bae
- Department of Surgery, College of Medicine, Soonchunhyang University Hospital, Cheonan, Republic of Korea
| | - Hae Il Jung
- Department of Surgery, College of Medicine, Soonchunhyang University Hospital, Cheonan, Republic of Korea
| | - Hyun-Deuk Cho
- Department of Pathology, College of Medicine, Soonchunhyang University Hospital, Cheonan, Republic of Korea
| | - Byong-Taek Lee
- Department of Regenerative Medicine, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
- Institute of Tissue Regeneration, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
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Application of Calcium Sulfate for Dead Space Management in Soft Tissue: Characterisation of a Novel In Vivo Response. BIOMED RESEARCH INTERNATIONAL 2018; 2018:8065141. [PMID: 29693016 PMCID: PMC5859833 DOI: 10.1155/2018/8065141] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/16/2018] [Indexed: 12/03/2022]
Abstract
Management of dead space (DS) is a fundamental aspect of surgery. Residual DS following surgery can fill with hematoma and provide an environment for bacterial growth, increasing the incidence of postoperative infection. Materials for managing DS include polymethyl-methacrylate (PMMA), which is nonresorbing and requires removal in a second surgical procedure. The use of calcium sulfate (CS) offers the advantage of being fully absorbed and does not require subsequent surgical removal. As CS has historically been used as a bone void filler, there are some concerns for the risk of heterotopic ossification (HO) when implanted adjacent to soft tissue. This study assessed the osteoinductive potential of CS and identified and characterised residual material present in muscle tissue using histology, energy-dispersive X-ray spectroscopy analysis, and scanning electron microscopy (SEM). CS beads with and without antibiotic were implanted in intramuscular sites in both athymic rats and New Zealand white rabbits. At 28 days after implantation in the rat model, no signs of osteoinduction were observed. In the rabbit model, at 21 days after implantation, almost complete bead absorption and presence of a “halo” of material in the surrounding muscle tissue were confirmed. Our results suggested that the halo of material was a calcium phosphate precipitate, not HO.
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