Effect of Polymethylmethacrylate-Hydroxyapatite Composites on Callus Formation and Compressive Strength in Goat Vertebral Body

Expression of osteopontin and osteocalcin in Osteoblast cells exposed to a combination of polymethylmethacrylate (PMMA) and hydroxyapatite (HAp): A prospective observational study

The success of implant placement will depend on the ability of the implant material to integrate with the surrounding tissue. Polymethylmethacrylate (PMMA) has been used as an implant material, but it has several fallback properties in its interaction with bone tissue. The addition of hydroxyapatite (HAp) to PMMA is expected to produce reinforced bioceramic polymers with better mechanical and biological properties. The purpose of this study was to evaluate the expression of osteopontin and osteocalcin in cultured osteoblasts when exposed to two implant candidate materials: PMMA-HApGMP, derived from bovine bone and processed under Good Manufacturing Practice by a Tissue Bank, and PMMA-HApBBK, sourced from limestone (CaCO3) and processed by Balai Besar Keramik. Twenty-four fetal rat calvariae osteoblast cell cultures were randomly divided into 6 groups: 7- and 14-day control group, 7 and 14 days PMMA-HApGMP group, 7 and 14 days PMMA-HApBBK group. The expression of osteopontin and osteocalcin was seen by immunocytochemical examination. The results showed that the average expression of osteopontin and osteocalcin in the treatment group on the 7th and 14th days was higher than the control group. The expression of osteopontin and osteocalcin in the PMMA-HApGMP group increased significantly (P < .05) on day 14. The PMMA-HAp combination material can accelerate the process of osteoblast differentiation which is characterized by an increase in osteopontin and osteocalcin which are markers of bone formation. This will support in increasing osseointegration.

New PMMA-Based Hydroxyapatite/ZnFe2O4/ZnO Composite with Antibacterial Performance and Low Toxicity

Polymethylmethacrylate (PMMA) is the most commonly used bone void filler in orthopedic surgery. However, the biocompatibility and radiopacity of PMMA are insufficient for such applications. In addition to insufficient biocompatibility, the microbial infection of medical implants is one of the frequent causes of failure in bone reconstruction. In the present work, the preparation of a novel PMMA-based hydroxyapatite/ZnFe2O4/ZnO composite with heterophase ZnFe2O4/ZnO NPs as an antimicrobial agent was described. ZnFe2O4/ZnO nanoparticles were produced using the electrical explosion of zinc and iron twisted wires in an oxygen-containing atmosphere. This simple, highly productive, and inexpensive nanoparticle fabrication approach could be readily adapted to different applications. From the findings, the presented composite material showed significant antibacterial activity (more than 99% reduction) against P. aeruginosa, S. aureus, and MRSA, and 100% antifungal activity against C. albicans, as a result of the combined use of both ZnO and ZnFe2O4. The composite showed excellent biocompatibility against the sensitive fibroblast cell line 3T3. The more-than-70% cell viability was observed after 1-3 days incubation of the sample. The developed composite material could be a potential material for the fabrication of 3D-printed implants.

Feldspar-Modified Methacrylic Composite for Fabrication of Prosthetic Teeth

This study was aimed at investigating poly(methyl methacrylate) (PMMA), modified with a silanized feldspar filler at 10 wt.% and 30 wt.%, as a dental material system for the production of prosthetic teeth. Samples of this composite were subjected to a compressive strength test, three-layer methacrylic teeth were fabricated with the said materials, and their connection to a denture plate was examined. The biocompatibility of the materials was assessed via cytotoxicity tests on human gingival fibroblasts (HGFs) and Chinese hamster ovarian cells (CHO-K1). The addition of feldspar significantly improved the material's compressive strength, with neat PMMA reaching 107 MPa, and the addition of 30% feldspar raising it up to 159 MPa. As observed, composite teeth (cervical part made of neat PMMA, dentin with 10 wt.%, and enamel with 30 wt.% of feldspar) had good adhesion to the denture plate. Neither of the tested materials revealed any cytotoxic effects. In the case of hamster fibroblasts, increased cell viability was observed, with only morphological changes being noticed. Samples containing 10% or 30% of inorganic filler were determined to be safe for treated cells. The use of silanized feldspar to fabricate composite teeth increased their hardness, which is of significant clinical importance for the duration of use of non-retained dentures.

RUNX2 and ALP expression in osteoblast cells exposed by PMMA-HAp combination: An in vitro study

Objective

To observe the expression of Runt-Related Transcription Factors 2 (RUNX2) and Alkaline Phosphatase (ALP) markers in osteoblast cell cultures exposed to Polymethylmethacrylate (PMMA) combined with hydroxyapatite (HAp) material to improve osteointegration of bone implants.

Methods

Sample of PMMA and HAp materials with a mixture of PMMA with HAp made from limestone as natural source which processed through Balai Besar Keramik (HApBBK) in the first group and a mixture of PMMA with HAp made from bovine bone which processed through Good Manufacturing Practice (HApGMP) in the second group. Twenty-four fetal rat calvarie osteoblast cell cultures were randomly divided into 6 groups: 7- and 14-day control group, 7 and 14 days PMMA-HApGMP group, 7 and 14 days PMMA-HApBBK group. The expression of RUNX2 and ALP was seen by immunocytochemical examination.

Result

The one-way ANOVA with a significance value of 0.000 (p < 0.05). There was an increase in RUNX2 and ALP expressions on both PMMA-HApBBK and PMMA-HApGMP groups on days 7 and 14 in osteoblast cell cultures.

Conclusion

The PMMA-HApBBK and PMMA-HApGMP showed an increase in the RUNX2 and ALP expression in osteoblast cell cultures which indicates a potential increase of osseointegration of bone implants.

Expression of VEGF and BMP-2 in Osteoblast cells exposed to a combination of polymethylmethacrylate (PMMA) and hydroxyapatite (HAp)

Objectives

Polymethylmethacrylate (PMMA) has been widely used, but it has several fallback properties in its interaction with bone tissue, so the addition of hydroxyapatite (HAp) material aims to improve the biocompatibility, regeneration process, and osteointegration of bone implants. The HAp material can be sourced from bovine bone and processed through Good Manufacturing Practice from Tissue Bank (HApGMP), and from limestone (CaCO3) processed by Balai Besar Keramik (HApBBK).This study was to observe the expression of vascular endothelial growth factor (VEGF) and Bone morphogenetic protein-2 (BMP2) in cultured osteoblasts exposed to PMMA-HApGMP and PMMA-HApBBK as implant candidate materials.

Methods

Sample of PMMA and HAp materials with a mixture of PMMA and HApBBK in the first group and a mixture of PMMA and HApGMP in the second group. Twenty-four fetal rat calvarie osteoblast cell cultures were randomly divided into 6 groups: 7- and 14-day control group, 7 and 14 days PMMA-HApGMP group, 7 and 14 days PMMA-HApBBK group. The expression of VEGF and BMP-2 was seen by immunocytochemical examination.

Results

The one-way ANOVA with a significance value of 0.000 (p < 0.05). BMP-2 and VEGF expression was increased in the 7- and 14-days groups after exposure to PMMA-HApGMP and PMMA-HApBBK.

Conclusion

The application of PMMA-HApGMP and PMMA-HApBBK showed an increase in the expression of VEGF and BMP-2 in osteoblast cell cultures which indicates a potential increase in the accelerated angiogenesis and osteogenesis in the bone regeneration process of bone implants.

Cytotoxicity and cell response of preosteoblast in calcium sulfate-augmented PMMA bone cement

Poly(methyl methacrylate) (PMMA) has been widely used in orthopedic applications, but bone ingrowth and toxic monomer release are drawback of this material. Particle reinforcement with osteoconductive substitute, such as calcium sulfate (CaSO₄), is one of the solutions used to modify PMMA bone cement. The current study investigated the mechanical, chemical and biological properties of CaSO₄-augmented bone cement. Mechanical strength was measured by a material testing machine. The concentration of methyl methacrylate (MMA) monomer from the various formulations of PMMA mixed with CaSO₄was measured by ultra-performance liquid chromatography (UPLC). CCK-8 assay and ALP assay were performed to evaluate cytotoxicity of released MMA monomer and cell differentiation. The attachment of cells to CaSO₄-augmented bone cement discs was observed by confocal and scanning electron microscopy, and surface topography was also evaluated by atomic force microscopy. The results revealed that increased CaSO₄weight ratios led to compromised mechanical strength and increased MMA monomer release. Cell density and cell differentiation on CaSO₄-augmented bone cement discs were decreased at CaSO₄weight ratios above 10%. In addition, the presence of micropores on the surface and surface roughness were both increased for PMMA composite discs containing higher levels of CaSO₄. These results demonstrated that fewer MC3T3-E1 cells on the surface of CaSO₄-PMMA composites was correlated to increased MMA monomer release, micropore number and surface roughness. In summary, the augmentation of a higher proportion of CaSO₄(>10 wt. %) to PMMA did not promote the biological properties of traditional PMMA bone cement.

Minimally invasive injectable lumbar interbody fusion with mineralized collagen-modified PMMA bone cement: A new animal model

This study was to develop a feasible and safe animal model for minimally invasive injectable lumbar interbody fusion using a novel biomaterial, mineralized collagen-polymethylmethacrylate bone cement (MC-PMMA), with unilateral pedicle screw fixation in an in vivo goat model. Eight goats (Capra aegagrus hircus) were divided into three groups: MC-PMMA, unmodified commercial-polymethylmethacrylate bone cement (UC-PMMA), and a control group (titanium cage filled with autogenous bone, TC-AB). Each group of goats was treated with minimally invasive lumbar interbody fusion at the L3/L4 and L5/L6 disc spaces (injected for MC-PMMA and UC-PMMA, implanted for TC-AB). The pedicle screws were inserted at the L3, L4, L5, and L6 vertebrae, respectively, and fixed on the left side. The characteristics of osteogenesis and bone growth were assessed at the third and the sixth month, respectively. The methods of evaluation included the survival of each animal, X-ray imaging, and 256-layer spiral computed tomography (256-CT) scanning, imaged with three-dimensional microfocus computed tomography (micro-CT), and histological analysis. The results showed that PMMA bone cement can be extruded smoothly after doping MC, the MC-PMMA integrates better with bone than the UC-PMMA, and all goats recovered after surgery without nerve damage. After 3 and 6 months, the implants were stable. New trabecular bone was observed in the TC-AB group. In the UC-PMMA group a thick fibrous capsule had formed around the implants. The MC-PMMA was observed to have perfect osteogenesis and bone ingrowth to adjacent bone surface. Minimally invasive injectable lumbar interbody fusion using MC-PMMA bone cement was shown to have profound clinical value, and the MC-PMMA showed potential application prospects.