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Bone Graft Substitute (bone + graft_substitute)
Selected AbstractsBioceramic Bone Graft Substitutes: Influence of Porosity and ChemistryINTERNATIONAL JOURNAL OF APPLIED CERAMIC TECHNOLOGY, Issue 3 2005Karin A. Hing Bioceramics have been considered for use as synthetic bone graft substitutes (BGSs) for over 30 years, throughout which there have been two primary areas of research: (i) optimization of the physical pore structure and (ii) formulation of an appropriate bioceramic chemistry. While it is well recognized that both the rate of integration and the final volume of regenerated bone are primarily dependent on the macroporosity, there still seems to be some dispute regarding the optimum "type" of porosity. The rate and quality of bone integration have, in turn, been related to a dependence on pore size, porosity volume fraction, and interconnection size and interconnection density, both as a function of structural permeability and mechano-transduction. Moreover, the role of strut microstructure and pore geometry have been considered with respect to their influence on entrapment and recruitment of growth factors (GFs) in addition to its influence on scaffold mechanics. Deconvoluting the relative affects of these parameters is complicated by the use of both resorbable and nonresorbable bioactive bioceramics, which are believed to mediate bioactivity in the osseous environment through two principal mechanisms: (i) directly through dissolution and release of ionic products in vivo, elevating local concentrations of soluble species that interact directly with local cells or influence cell behavior by their effect on local pH, (ii) indirectly through the influence that surface chemistry will have on protein adsorption, GF entrapment, and subsequent cell attachment and function. This article aims to review some of the recent developments in bioceramic BGSs, with a view to understanding how the various physiochemical parameters may be optimized to promote bone healing. [source] Submerged healing following surgical treatment of peri-implantitis: a case seriesJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2007Ann-Marie Roos-Jansĺker Abstract Objectives: The aim was to study a regenerative surgical treatment modality for peri-implantitis employing submerged healing. Material and Methods: Twelve patients, having a minimum of one osseointegrated implant with peri-implantitis, with a progressive loss of 3 threads (1.8 mm) following the first year of healing were involved in the study. After surgical exposure of the defect, granulomatous tissue was removed and the implant surface was treated using 3% hydrogen peroxide. The bone defects were filled with a bone substitute (Algipore®), a resorbable membrane (Osseoquest®) was placed over the grafted defect and a cover screw was connected to the fixture. The implant was then covered by flaps and submerged healing was allowed for 6 months. After 6 months the abutment was re-connected to the supra-structure. Results: A 1-year follow-up demonstrated clinical and radiographic improvements. Probing depth was reduced by 4.2 mm and a mean defect fill of 2.3 mm was obtained. Conclusion: Treatment of peri-implant defects using a bone graft substitute combined with a resorbable membrane and submerged healing results in defect fill and clinical healthier situations. [source] A resorbable porous ceramic composite bone graft substitute in a rabbit metaphyseal defect modelJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 4 2003W. R. Walsh The success of converted corals as a bone graft substitute relies on a complex sequence of events of vascular ingrowth, differentiation of osteoprogenitor cells, bone remodeling and graft resorption occurring together with host bone ingrowth into and onto the porous coralline microstructure or voids left behind during resorption. This study examined the resorption rates and bone infiltration into a family of resorbable porous ceramic placed bilaterally in critical sized defects in the tibial metaphyseal,diaphyseal of rabbits. The ceramics are made resorbable by partially converting the calcium carbonate of corals to form a hydroxyapatite (HA) layer on all surfaces. Attempts have been made to control the resorption rate of the implant by varying the HA thickness. New bone was observed at the periosteal and endosteal cortices, which flowed into the centre of the defect supporting the osteoconductive nature of partially converted corals. The combination of an HA layer and calcium carbonate core provides a composite bone graft substitute for new tissue integration. The HA-calcium carbonate composite demonstrated an initial resorption of the inner calcium carbonate phase but the overall implant resorption and bone ingrowth behaviour did not differ with HA thickness. © 2003 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source] Electrospun poly(L -lactic acid)/hydroxyapatite composite fibrous scaffolds for bone tissue engineering,POLYMER INTERNATIONAL, Issue 2 2010Boontharika Chuenjitkuntaworn Abstract Poly(L -lactic acid) (PLLA) is one of the most studied synthetic biodegradable polymeric materials as a bone graft substitute. Taking into account the osteoconductive property of hydroxyapatite (HAp), we prepared fibrous matrices of PLLA without and with HAp particles in amounts of 0.25 or 0.50% (w/v, based on the volume of the base 15% w/v PLLA solution in 70:30 v/v dichloromethane/tetrahydrofuran). These fibrous matrices were assessed for their potential as substrates for bone cell culture. The presence of HAp in the composite fibre mats was confirmed using energy dispersive X-ray spectroscopy mapping. The average diameters of both neat PLLA and PLLA/HAp fibres, as determined using scanning electron microscopy, ranged between 2.3 and 3.5 µm, with the average spacing between adjacent fibres ranging between 5.7 and 8.5 µm. The porosity of these fibrous membranes was high (ca 97,98%). A direct cytotoxicity evaluation with L929 mouse fibroblasts indicated that the neat PLLA fibre mats released no substance at a level that was toxic to the cells. The presence of HAp particles at 0.50% w/v in the PLLA fibrous scaffolds not only promoted the attachment and the proliferation of MC3T3-E1 mouse pre-osteoblastic cells, but also increased the expression of osteocalcin mRNA and the extent of mineralization after the cells had been cultured on the scaffolds for 14 and 21 days, respectively. The results obtained suggested that the PLLA/HAp fibre mats could be materials of choice for bone tissue engineering. Copyright © 2009 Society of Chemical Industry [source] The use of porous calcium phosphate scaffolds with transforming growth factor beta 1 as an onlay bone graft substituteCLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2004An experimental study in rats Abstract Objectives: Autogeneous bone grafting is regarded to be the golden standard for onlay grafts, but it requires a harvesting procedure and the remodeling pattern over time is unpredictable. New materials are constantly being sought to overcome these problems. An in vivo experiment was carried out to evaluate whether (1) porous calcium phosphate cement is a suitable biomaterial for onlay bone grafting, and (2) the addition of transforming growth factor beta 1 (TGF-,1) accelerates de novo bone formation inside the cement porosity. Material and methods: A carrier of porous calcium phosphate cement (Calcibon®) was designed and 16 rats received one preshaped implant each. In 8 out of 16 implants 0.75 ,g TGF-,1 was applied. The animals were killed after 4 weeks and the characteristics of tissue ingrowth into the onlay graft were evaluated. Results: Histologic and quantitative histomorphometrical measurements demonstrated osteoid-like tissue formation in both experimental groups. The addition of TGF-,1 did not induce significantly more osteoid-like tissue formation. On the other hand, in TGF-,-loaded implants, a higher number of pores contained an inflammatory infiltrate. Conclusion: This study indicated that porous calcium phosphate cement is a promising material for clinical situations where bone formation has to be supported. Résumé La greffe osseuse autogčne est considérée comme la meilleure technique actuelle pour les greffons onlay mais elle requiert un processus de prélevement et le remodelage qui s'en suit est imprévisible. De nouveaux matériaux sont donc constamment recherchés. Cette étude in vitro a essayé d'évaluer si 1) le cément phosphate calcium poreux était un biomatériel favorable pour le greffage osseux onlay, 2) si l'addition de TGF-,1 accélérait la néoformation osseuse ŕ l'intérieur de la porosité du cément. Un porteur de cément phosphate calcium poreux (Calcibon®) a été fabriqué et seize rats ont reçu chacun un implant prédécoupé. Au niveau de huit des seize implants 0,75 ,g de TGF ,1 a été appliqué. Les animaux ont été euthanasiés aprčs quatre semaines et les caractéristiques de la croissance interne tissulaire dans le greffon onlay ont étéévaluées. Les mesures histologiques et histomorphométriques quantitatives ont démontré une formation tissulaire semblable ŕ l'ostéogénie dans les deux groupes expérimentaux. L'addition de TGF-ß1 n'induisait pas plus de formation tissulaire ressemblant ŕ celle d'ostéogénie. D'un autre côté, dans les implants chargés de TGF-,1, un nombre plus important de pores contenaient un infiltrat inflammatoire. Cette étude indique que le cément phosphate calcium poreux est un matériau prometteur pour les situations cliniques dans lesquelles la formation osseuse doit ętre améliorée. Zusammenfassung Ziel: Die Transplantation von autologem Knochen wird heute als Goldstandard für die Onlay-Transplantate betrachtet. Es braucht dazu aber einen zusätzlichen Eingriff für die Entnahme und eine Prognose bezüglich der anschliessenden Remodellationsvorgänge sind kaum möglich. Man sucht ständig nach neuen Produkten, um diese Probleme zu überwinden. Man führte eine in vivo Studie durch und untersucht, ob (1) ein poröser Kalziumphosphatzement ein brauchbares Biomaterial für ein Onlay-Transplantat ist, und (2) der Zusatz von TGF-,1 die Neubildung von Knochen in den Porositäten des Zementes positiv beeinflusst. Material und Methode: Man entwickelte einen Trägerzement aus porösem Kalziumphosphat (Calcibon®) und 16 Ratten erhielten je ein vorgeformtes Implantat eingesetzt. Bei 8 der 16 Implantate fügte man zusätzlich 0.75 ,g TGF-,1 dazu. Vier Wochen später opferte man die Tiere und konnte nun die Charakteristika des in die Implantate einwachsenden Gewebes untersuchen. Resultate: Die histologischen und quantitativen histomorphometrischen Messungen zeigten in beiden experimentellen Gruppen osteoidähnliche Gewebsbildungen. Der Zusatz von TGF-,1 bewirkte keine signifikante Zunahme dieser osteoidähnlichen Gewebsbildungen. Die mit TGF-,1 durchsetzten Implantate enthielten aber mehr mit entzündlichem Infiltrat angefüllte Poren. Zusammenfassung: Diese Arbeit zeigte uns, dass ein poröser Kalziumphosphatzement bei klinischen Situationen, wo die Knochenbildung unterstützt werden muss, ein erfolgsversprechendes Material ist. Resumen Objetivos: El injerto de hueso autógeno está considerado como el estándar de oro para injertos superpuestos, pero requiere un procedimiento de recolección y el patrón de remodelado a lo largo del tiempo es impredecible. Constantemente se están buscando materiales nuevos para superar estos problemas. Se llevó a cabo un experimento in vivo para evaluar si (1) el cemento de fosfato cálcico poroso es un biomaterial apropiado para injerto óseo superpuesto, y (2) la adición de TGF-,1 acelera la formación de hueso de novo dentro de la porosidad del cemento. Material y Métodos: Se diseńó un portador de cemento de fosfato cálcico (Calcibon®) y 16 ratas recibieron un implante preformado cada una. En 8 de 16 implantes se aplicaron 0.75 ,g de TGF-,1. Los animales se sacrificaron tras 4 semanas y se evaluaron las características del tejido crecido hacia adentro del injerto superpuesto. Resultados: Las mediciones histológicas e histomorfométricas cuantitativas demostraron formación de tejido tipo osteoide en ambos grupos experimentales. La adición de TGF-,1 no indujo significativamente más formación de tejido tipo osteoide. Por otro lado, en los implantes cargados con TGF-,1, un mayor número de de poros contenían infiltrado inflamatorio. Conclusión: Este estudio indica que el cemento de fosfato cálcico poroso es un material prometedor para situaciones clínicas donde la formación de hueso ha de ser favorecida. [source] Bioceramic Bone Graft Substitutes: Influence of Porosity and ChemistryINTERNATIONAL JOURNAL OF APPLIED CERAMIC TECHNOLOGY, Issue 3 2005Karin A. Hing Bioceramics have been considered for use as synthetic bone graft substitutes (BGSs) for over 30 years, throughout which there have been two primary areas of research: (i) optimization of the physical pore structure and (ii) formulation of an appropriate bioceramic chemistry. While it is well recognized that both the rate of integration and the final volume of regenerated bone are primarily dependent on the macroporosity, there still seems to be some dispute regarding the optimum "type" of porosity. The rate and quality of bone integration have, in turn, been related to a dependence on pore size, porosity volume fraction, and interconnection size and interconnection density, both as a function of structural permeability and mechano-transduction. Moreover, the role of strut microstructure and pore geometry have been considered with respect to their influence on entrapment and recruitment of growth factors (GFs) in addition to its influence on scaffold mechanics. Deconvoluting the relative affects of these parameters is complicated by the use of both resorbable and nonresorbable bioactive bioceramics, which are believed to mediate bioactivity in the osseous environment through two principal mechanisms: (i) directly through dissolution and release of ionic products in vivo, elevating local concentrations of soluble species that interact directly with local cells or influence cell behavior by their effect on local pH, (ii) indirectly through the influence that surface chemistry will have on protein adsorption, GF entrapment, and subsequent cell attachment and function. This article aims to review some of the recent developments in bioceramic BGSs, with a view to understanding how the various physiochemical parameters may be optimized to promote bone healing. [source] In vivo investigations on composites made of resorbable ceramics and poly(lactide) used as bone graft substitutesJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 6 2001Anita A. Ignatius Abstract Porous composites made of poly(L, DL-lactide) (PLA) and ,-tricalcium phosphate (,-TCP) or the glass ceramic, GB14N, respectively, were investigated in a loaded implant model in sheep. Six, 12 and 24 months after implantation histological and biomechanical evaluation were performed and compared to autogenous bone transplants. No significant differences were observed between the composites. After 6 months, the interconnecting pores of the ,-TCP-composite and the GB14N-composite were filled with newly formed bone (14 ± 5% or 29 ±15% of the implant, respectively) and soft tissue (30 ±9% or 21 ±12% of the implant, respectively). Only a mild inflammatory response was observed. The reaction was similar after 12 months. However, after 24 months a strong inflammatory reaction was seen. The newly formed bone was partly osteolytic. The adverse reaction occurred simultaneously to a significant reduction of the PLA component. The histological results were reflected by the biomechanical outcomes. Both composites showed compression strengths in the range of the autologous bone graft until 12 months of implantation. After 2 years, however, the strengths were significantly decreased. It is concluded that the new composites cannot yet be used for clinical application. An improvement in biocompatibility might be reached by a better coordination of the degradation times of the polymer and the ceramic component. © 2001 John Wiley & Sons, Inc. J Biomed Mater Res (Appl Biomater) 58: 701,709, 2001 [source] Accuracy and precision of radiostereometric analysis in the measurement of three-dimensional micromotion in a fracture model of the distal radiusJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 2 2005Rami Madanat Abstract The purpose of the current study was to verify the feasibility of radiostereometric analysis (RSA) in monitoring three-dimensional fracture micromotion in fractures of the distal radius. The experimental set-up consisted of a simulated model of an extra-articular Colles' fracture, including metallic beads inserted into the bone on either side of the fracture site. The model was rigidly fixed to high precision micrometer stages allowing controlled translation in three axes and rotation about the longitudinal and transverse axes. The whole construct was placed inside a RSA calibration cage with two perpendicular radiographic film cassettes. Accuracy was calculated as the 95% prediction intervals from the regression analyses between the micromotion measured by RSA and actual displacements measured by micrometers. Precision was determined as the standard deviation of five repeated measurements of a 200 ,m displacement or a 0.5° rotation along a specific axis. Translations from 25 ,m to 5 mm were measured with an accuracy of ±6,m and translations of 200,m were measured with a precision of 2,6 ,m. Rotations ranging from 1/6° to 2° were measured with an accuracy of ±0.073° and rotations of 1/2° were measured with a precision of 0.025°,0.096°. The number of markers and their configuration had greater impact on the accuracy and precision of rotation than on those of translation. Aside from the unknown rate of clinical marker loosening, the current results favor the use of at least four markers in each bone fragment in distal radius fractures. These results suggest a strong rationale for the use of RSA as an objective tool for comparing different treatment modalities and novel bone graft substitutes aimed at stabilization of fractures of the distal radius. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] Healing of rabbit calvarial bone defects using biphasic calcium phosphate ceramics made of submicron-sized grains with a hierarchical pore structureCLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2010Jin-Woo Park Abstract Objectives: This study investigated the efficacy of new bone graft substitutes , biphasic calcium phosphates (BCP) made of submicron-sized grains with fully interconnected wide-range micron-scale pores in two different macrodesigns: donut shaped with a 300,400 ,m central macropore (n-BCP-1) or rod-shaped (n-BCP-2) , in the healing of rabbit calvarial defects, and compared their bone-healing properties with those of various commercial bone substitutes, which included substitutes with similar BCP composition (MBCP and Osteon), anorganic bovine bone (Bio-Oss), and ,-TCP (Cerasorb). Material and methods: The surface morphology of the bone substitutes was investigated using scanning electron microscopy (SEM). Defects 8 mm in diameter were created in the calvaria of 30 adult male New Zealand White rabbits and were filled with six types of bone substitutes. The percentage of newly formed bone (NB%) was evaluated histomorphometrically 4 and 8 weeks after implantation. Results: SEM observation showed submicron-sized grains with fully interconnected micropore structures in the n-BCP-1 and n-BCP-2 groups; these groups also showed considerable new bone formation in inner micropores as well as on the outer surfaces. The n-BCP-1 group exhibited enhanced new bone formation and direct ingrowth of bone tissue with blood vessels into central pores. Histomorphometric analysis showed significantly greater NB% in the n-BCP-1 group when compared with the other groups at 4 and 8 weeks (P<0.05). Conclusion: A new BCP ceramics made of submicron-sized grains with a hierarchical pore structure was an effective osteoconductive material for the treatment of osseous defects of rabbit calvaria. To cite this article: Park J-W, Kim E-S, Jang J-H, Suh J-Y, Park K-B, Hanawa T. Healing of rabbit calvarial bone defects using biphasic calcium phosphate ceramics made of submicron-sized grains with a hierarchical pore structure. Clin. Oral Impl. Res. 21, 2010; 268,276. doi: 10.1111/j.1600-0501.2009.01846.x [source] | |||||||||||||