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Biomedical subjects

Minna Kellomäki

Publications and source records attributed to Minna Kellomäki.

15 recordsLinked to original sources

Tyrosine-derived polycarbonate membrane in treating mandibular bone defects. An experimental study.

This study was designed to evaluate the suitability of a novel bioabsorbable material in treating bone defects. A poly(desaminotyrosyl-tyrosine-ethyl ester carbonate) (PDTE carbonate) membrane (thickness 0.2-0.3 mm) was implanted into the mandibular angle of 20 New Zealand White rabbits to cover a through-and-through defect (12 x 6 mm). In group 1, the defects were left unfilled but covered with membrane and in group 2 the defects were filled with bioactive glass mesh and covered with membrane, too. Controls were left uncovered and unfilled. The animals were followed for 6, 12, 24 and 52 weeks, respectively. The material was evaluated by qualitative analysis of histological reactions and newly formed bone. We found that PDTE carbonate elicited a modest foreign body reaction in the tissues, which was uniform throughout the study. New bone formation was seen in all samples after six weeks. Group 1 had more new bone formation until 24 weeks and after this the difference settled. Based on findings of this study it was concluded that PDTE carbonate membranes have good biocompatibility and are sufficient to enhance bone growth without additional supportive matrix.

Animals↗

Fibre reinforced bioresorbable composites for spinal surgery.

Composites containing different amounts of beta-tricalcium phosphate (beta-TCP) embedded in a poly-lactide (PLA70) matrix with and without poly-lactide (PLA96) fibre reinforcement were studied and the feasibility of using these composites in spinal fusion implants was examined. Compressive yield strength was measured in two directions: parallel to (83-97 MPa) and perpendicular to (108-123 MPa) the laminated structure of the composites. In the parallel direction, the addition of beta-TCP decreased compressive yield strength while in the perpendicular direction this was increased when compared to plain specimens (p<0.05). Fibre reinforcement had no significant effect on compressive yield strength (p<0.05), but did increase impact strength by 127-216% for notched specimens (parallel direction) and by about 65% for un-notched specimens (perpendicular direction) (p<0.05). A 24 week in vitro analysis of implant prototypes in simulated body fluid revealed a decrease in compressive yield strength, which was greater for the samples containing 50 wt.% beta-TCP than for those containing 25 wt.% beta-TCP. After 12 weeks incubation the composites retained 66-99% of their initial compressive strength, depending on composition. After 24 weeks incubation the lowest compressive strength was 51% (56 MPa: 50/50) and the highest was 94% (90 MPa: 75/25) of the initial value. Calcium phosphate precipitation on the surfaces of the materials in vitro was also observed. The initial compressive strengths of the studied composites were comparable to materials used in spinal fusion applications, but adequate strength retention behaviour needs to be confirmed before undertaking clinical experiments.

Biocompatible Materials↗

Effect of FGF and polylactide scaffolds on calvarial bone healing with growth factor on biodegradable polymer scaffolds.

Repair of bone defects remains a major concern in reconstructive surgery. Synthetic biodegradable polymers have been used as scaffolds for guided bone regeneration. Fibroblast growth factors (FGFs) promote cell growth, differentiation, and tissue maintenance factors. They can stimulate the proliferation of osteogenic cells and chondrocytes, and also promote angiogenesis. Acidic and basic fibroblast growth factors (FGF-1 and FGF-2, respectively) are the best known members of this protein family. To evaluate the healing of experimental bone defects using poly-L/D-lactide (PLDLA) 96/4 scaffolds and FGF-1, 18 adult rats were operated on. A 6-mm diameter critical size defect (CSD) was made in the calvarial bone of each rat. The animals were divided into three treatment groups: 1) Neither scaffold nor FGF was used (control group); 2) scaffold only; and 3) scaffold with FGF-1. Follow-up time was eight weeks. Samples were embedded in methylmethacrylate and 5-microm thick sections from the middle of each specimen were stained with modified Masson-Goldner method. The shape and size of defects were evaluated radiologically. New bone formation was measured histologically and histomorphometrically. Radiologically, in the control group the shape of the defects changed from round to oval and edges were blunt. In the other groups the defects were round with sharp edges. Histomorphometrically, mean surface area of bone trabeculae was 1.05 mm (SD +/- 0.25) in group 1 (no implant), 1.35 mm (SD +/- 0.52) in group 2 (implant) and 0.79 mm (SD +/- 0.34) in group 3 (implant and FGF-1). Histological examinations revealed no or little osteoid in the groups 1 and 2, whereas in the group 3 samples had little or moderate new bone formation. Accordingly, no clear benefit of using knitted PLDLA scaffolds combined with FGF-1 on the healing of calvarial critical size defects in rats could be demonstrated.

Animals↗

Poly-L/D-lactide (PLDLA) 96/4 fibrous implants: histological evaluation in the subcutis of experimental design.

Poly-L/D-lactide (PLDLA) 96/4 fibrous implants have been introduced to engineer functional fibrous constructions in situ. The current study was undertaken to evaluate the guidance of the fibrous tissue formation and the tissue reaction of porous PLDLA 96/4 scaffolds implanted in subcutaneous tissue. Three various PLDLA 96/4 knitted-mesh scaffolds (Loose, Ordinary, and Dense) were implanted subcutaneously in 32 rats, and followed-up from 3 days until 48 weeks postsurgery. Histological examination showed that PLDLA 96/4 scaffolds provided a structurally supporting element for 48 weeks. They were filled with fibrous tissue by 3 weeks. During the follow-up, loose connective tissue was organized into dense connective tissue with thick collagen bundles. At 48 weeks, no statistically significant difference was found in the amount of loose or dense connective tissue between the scaffold groups of various porosities, although the tendency for higher amounts of loose connective tissue was seen in the Loose type scaffolds. PLDLA filament diameters were 121 mum at 2 weeks, 119 mum at 24 weeks and 116 mum at 48 weeks (P = 0.03 between 2 and 48 weeks). Porous PLDLA scaffold induced fibrous tissue formation in situ. This can be exploited in engineering fibrous tissue constructs in vivo for tissue support or replacement purposes.

Absorbable Implants↗

Histologic analysis of bioabsorbable scleral buckling implants: an experimental study on rabbits.

PURPOSE: To analyze histologically tissue reactions to bioabsorbable PLA96 in rabbit eyes. METHODS: Scleral buckling operations were carried out in 48 rabbits. Two materials were used: bioabsorbable PLA96 (polylactide 96/4; L/D molar ratio 96/4) and silicone sponge. One eye of each rabbit was operated on and the other eye served as a nonoperated control. After follow-up times of 1, 3, 5, and 12 months, the rabbits were killed and the eyes enucleated for histology. RESULTS: All rabbits recovered well. Histologically, tissue reactions were very localized; implant fragments were not seen within the sclera. The amounts of fibrous tissue and inflammatory cells (mainly macrophages) inside the implant area increased over time. One rabbit from the silicone group was killed 4 months postoperatively owing to refusal to eat. In the PLA96 group, acute or chronic infections occurred in four rabbits. The bioabsorbable implant was macroscopically easily detectable at 12 months postoperatively. CONCLUSIONS: The PLA96 material used for scleral buckling in rabbits showed good biocompatibility. The material did not undergo biodegradation during the follow-up period of 12 months. PLA96 implants were associated with thicker fibrous tissue encapsulation and more inflammatory cells compared with silicone sponge implants.

Absorbable Implants↗

Drug-eluting biodegradable poly-D/L-lactic acid vascular stents: an experimental pilot study.

PURPOSE: To evaluate in vivo a new drug-eluting biodegradable vascular stent with respect to biocompatibility, neointimal hyperplasia formation, and reliability. METHODS: Self-expanding biodegradable poly-96L/4D-lactic acid (PLA) stents with 2 drugs (PLA + dexamethasone [DEX] and PLA + simvastatin [SIM]) and 2 different coatings (PLA + P(D,L)LA and PLA + polycaprolactone [PCL]) were compared with a self-expanding stainless steel Wallstent. The stents were implanted in both common iliac arteries of 8 pigs. Prior to sacrifice at 1 month, angiography was performed to determine patency. Specimens were harvested for quantitative histomorphometry; vascular injury and inflammation scores were assigned to the stented iliac segments. RESULTS: All stented arteries were angiographically patent. The mean luminal diameter (3.05 mm) and area (30.36 mm2) of DEX-eluting PLA stents were decreased compared to other stents (PLA + P(D,L)LA: 3.66 mm and 43.92 mm2; PLA + SIM: 4.21 mm and 56.48 mm2; PLA + PCL: 4.19 mm and 54.64 mm2; Wallstent: 5.01 mm and 81.19 mm2). Wallstents and DEX-eluting PLA stents induced minimal intimal hyperplasia: PLA + DEX: 0.16 mm, PLA + P(D,L)LA: 0.35 mm, PLA + SIM: 0.33 mm, PLA + PCL: 0.29 mm, and Wallstent: 0.18 mm. The vascular injury scores demonstrated only mild vascular trauma for all stents. Only mild to moderate inflammatory reaction was noted around stent struts with a vascular inflammation score. CONCLUSIONS: Biodegradable polymer stents appear to be biocompatible and reliable, causing minimal neointimal hyperplasia. Furthermore, the new biodegradable poly-D/L-lactic acid stent can be used as a local drug delivery vehicle. The DEX-eluting PLA stent reduces neointimal hyperplasia. The findings show a need for further investigation to prove the efficacy and safety of this new biodegradable drug-eluting stent.

Absorbable Implants↗

In vitro and in vivo behavior of self-reinforced bioabsorbable polymer and self-reinforced bioabsorbable polymer/bioactive glass composites.

The aim of this study was to investigate the in vitro and in vivo properties and degradation of (1) self-reinforced (SR) lactide copolymer, P(L/DL)LA 70:30, and (2) SR composites of the same polylactide and bioactive glass 13-93. The following three polymer and polymer-bioactive glass samples were studied: SR-PLA70, SR-PLA70 + BaG15s, and SR-PLA70 + BaG20c. In vitro behavior was studied in a phosphate-buffered saline for 87 weeks at 37 degrees +/- 1 degrees C and a pH of 7.4 +/- 0.2. In vivo behavior was studied by implanting the rods in the dorsal subcutaneous tissue of rats (SR-PLA70 + BaG20c) or rabbits (SR-PLA70 and SR-PLA70 + BaG15s) for 48 weeks. The degradation of the specimens was evaluated by measuring the changes in mechanical properties, crystallinity and molecular weight of polymer, water absorption, weight loss, and structural changes. Results showed that the addition of bioactive glass filler modified the degradation kinetics and material morphology.

Absorbable Implants↗

Biodegradable self-expanding poly-L/D-lactic acid vascular stent: a pilot study in canine and porcine iliac arteries.

PURPOSE: To report results of an in vivo pilot study to evaluate the biocompatibility and delivery system of a new biodegradable vascular stent and validate the study design. METHODS: Two self-expanding intravascular stents, a biodegradable poly-D/L-lactic acid (PLA) and a medical stainless steel stent (Wallstent) were implanted in the common iliac arteries of 2 postpuberal female pigs and 3 laboratory-bred beagle dogs. Specimens were harvested after 45 days in the dogs and 32 days in the pigs for histomorphometry of the stented iliac artery segments. Preliminary measurements were made to assess the reliability of the quantitative histomorphometric measurements before final measurements. RESULTS: Histomorphometry analyses showed that mean luminal diameter and area were decreased in the PLA stent group (1.97+/-0.48 mm and 14+/-6.4 mm2, respectively) compared to the control stent group (4.28+/-0.83 mm and 61+/-19 mm2, respectively). The intimal thickness was higher in the PLA stent group (0.65+/-0.07 mm) than in the control group (0.44+/-0.21 mm). The mean injury score was 0.19+/-0.12 in the PLA stent group and 0.78+/-0.39 in the controls. In the PLA stent group, the mean inflammation score was 1.46+/-0.78 compared to 0.58+/-0.40 in the control group. There were no differences observed between the animal models. CONCLUSIONS: The PLA stent showed increased neointimal formation and reduced patency during early follow-up. Mechanical properties of the new biodegradable vascular stents are still inadequate, and the stent and the delivery device require modifications. The study methods were assessed as reliable and reproducible.

Animals↗

Tissue reactions of subcutaneously implanted mixture of epsilon-caprolactone-lactide copolymer and tricalcium phosphate. An electron microscopic evaluation in sheep.

Biodegradable polymers, mainly derivates of alpha-hydroxy acids, are widely used today in oral- and maxillofacial surgery, orthopedics, and other fields of surgery. These biomaterials are well tolerated by living tissue and fracture fixation devices made of polylactic or polyglycolic acid are clinically widely used today. Still, there are some problems in application of biodegradable polymers. Abacterial inflammatory reactions have been noticed after the clinical introduction of these devices. Both swelling and pain at the site of implantation have also been reported. The etiology of this inflammatory reaction is still unknown, despite the numerous studies. Therefore, the aim of the present study was to further characterize this inflammatory reaction in detail, by electronmicroscopy. We prepared a mixture of epsilon-caprolactone-lactide copolymer and tricalcium phosphate and placed it in the dermis in 12 sheep. Follow-up times were 9, 14, 24, and 52 weeks. We found that the mixture caused a mild inflammatory reaction. There were no signs of cell damage. Fibroblasts, macrophages, and eosinophils were found adjacent to the copolymer. The mixture is easy to handle and can be moulded into different shapes in room temperature. The results encourage us to continue our studies to develop a filling material for bone defects.

Journal Article↗

Holding power of bioabsorbable self-reinforced poly-L/DL-lactide 70/30 tacks and miniscrews in human cadaver bone.

Several bioabsorbable internal fixation systems are currently in use in the field of bone surgery. To test the mechanical properties of recently developed amorphous self-reinforced poly-L/DL-lactide [SR-P(L/DL)LA] 70/30 tacks in comparison with commercially available SR-P(L/DL)LA 70/30 (BioSorbFX; Bionx Implants Ltd) miniscrews, SR-P(L/DL)LA miniscrews (length = 6.0 mm, core diameter = 1.5 mm, thread diameter = 2.0 mm) and tacks (length = 5.4 mm, core diameter = 1.5 mm, thread diameter = 2.0 mm) were applied to human cadaveric metatarsal (MT) bones (6 pairs of fourth MT bones and 6 pairs of fifth MT bones from donors who were from 29 to 56 years of age at the time of death). Pullout force was measured using a mechanical testing machine. Forty-eight pullout tests were carried out for each implant type. The Student test, Mann-Whitney test, and Spearman coefficient were used for statistical evaluation. The pullout force of tacks was 135.0 +/- 26.1 N, and that of the miniscrews was 119.3 +/- 26.1 N ( = 0.04, statistically significant difference). Accordingly novel SR-P(L/DL)LA 70/30 tacks have a statistically better pullout strength than the SR-P(L/DL)LA 70/30 miniscrews when tested in cadaver MT bones.

Absorbable Implants↗

Requirements for quantitative analysis of intimal reaction in arteries treated with intraluminal stents.

PURPOSE: To assess the reliability of quantitative histomorphometry measurements for the intimal reaction that occurs after intraluminal stenting in an animal model. METHODS: Two self-expanding intravascular stents, a biodegradable poly-D/L-lactic acid (PLA) stent and a stainless steel Wallstent, were implanted in the common iliac arteries of a beagle dog. After 45 days, the histomorphometry of the stented iliac artery segments was quantitatively measured. The relative standard error (RSE) of the estimate was calculated, and the reliability of measurements for maximal (LDmax) and minimal (LDmin) luminal diameters and internal (IELT) and external (EELT) elastic lamina thicknesses was assessed. RESULTS: The PLA stent required more measurements of variables from a single slide to ensure reliable (RSE<10%) results (1 for LDmax, 1 for LDmin, 8 for IELT, and 4 for EELT) compared to the Wallstent (1 for LDmax, 1 for LDmin, 2 for IELT, and 2 for EELT 2). The measured results were reliable for both stent materials when variables were measured from 2 slides of each segment (proximal/central/distal) of the stent. CONCLUSIONS: We conclude that these preliminary measurements to estimate the reliability of quantitative histomorphometry measurements should be made and reported before final results are given.

Animals↗

Bone tissue engineering: treatment of cranial bone defects in rabbits using self-reinforced poly-L,D-lactide 96/4 sheets.

This study is one of a series in which the authors evaluate various absorbable sheets to guide bone regeneration in cranial bone defects. The aim was to evaluate the use of self-reinforced poly-L,D-lactide 96/4 (SR-PLA96) sheets for cranial bone tissue engineering in experimental defects in rabbits. Square defects of 10 x 10 mm were created in the right parietal bone. SR-PLA96 implants (15 x 15 mm) were used to cover these defects in 12 New Zealand White rabbits. Similar defects were created in the left parietal bone, but no sheets were used (controls). The rabbits were killed after 6, 24, or 48 weeks. Histology and histomorphometry were used to evaluate healing of the defects. Defects covered with SR-PLA96 sheets showed more abundant bone formation than control (non-covered) defects. At 6 weeks, the defects were occupied mainly by fibrous tissue. At 24 weeks, healing with bone formation was more obvious in the covered defects. At 48 weeks, bone completely bridged defects covered with SR-PLA96 sheets, and incomplete bridging was seen in non-covered control defects. Hence, bone tissue engineering in experimental cranial bone defects in rabbits can be achieved using SR-PLA96 sheets to guide bone regeneration.

Absorbable Implants↗

Persistence of indentation with bioabsorbable poly-L/D-lactide versus silicone sponge scleral buckling implants.

PURPOSE: To measure the amount and duration of indentation depth achieved with biodegradable poly-L/D-lactide 96/4 (PLA96) and silicone sponge implants. METHODS: Thirty rabbits underwent a scleral buckling procedure. A PLA96 buckling implant was used in 15 rabbits and a silicone sponge buckling implant was in 15 rabbits. A circumferential scleral buckling implant was sutured episclerally on the left eye of each rabbit, just temporal to the superior rectus muscle and 7 mm posterior to the limbus. Computed tomography was performed at 1 week, 3 months, and 5 months after surgery. RESULTS: The PLA96 buckling implant (implant diameter, 3-3.5 mm) used in this study created lower indentation than the silicone sponge implant (implant diameter, 4 mm). The indentation created by the PLA96 implant decreased over time compared with that created by the silicone implant. There were no complications related to either kind of implant. CONCLUSION: Both the silicone sponge implant and the PLA96 implant caused indentation that decreased in a comparable manner over the follow-up period (5 months).

Absorbable Implants↗