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PubMedDate not supplied

Transplantation of new autologous biomaterials into jaw cleft.

This study compared bone-marrow grafting using chondroid or fibula bone grafts transplanted into simulated alveolar bone defects in mice. The osteogenic procedure was also investigated. As an experimental model of the maxillary alveolar bone cleft, suitable for testing bone-inductive materials, a surgical trephine with a low-speed dental engine was used to form critical-sized defects in the pre-maxillary bones of male mice. Distraction osteogenesis was performed using an external fixation device. The osteotomy site was surrounded by an external callus, consisting of hyaline cartilage, that contained a large quantity of chondroid bone. Transplanted bone within chondroid bone was characterized by bone formation and remodelling 30 days post-transplantation, and bone adhesion following chondroid bone grafting was better than adhesion following fibula grafting. The present findings are the first to demonstrate the potential of chondroid bone transplantation as a new therapeutic system of bone grafting, suitable for bone substitution in craniofacial bone defects.

Animals↗
PubMed2004

Gross, radiology and ultrasonographic evaluation of coral post-implantation in sheep femur.

The study was carried out to evaluate macroscopically the ability of coral to repair a large size bone defect. A total 12 adult, male sheep were used in the study. The large bone defect (2.5cm x 0.5cm x 0.5cm) was created surgically on the left proximal femur and replaced by a block of coral (Porites sp.). Radiographs were obtained immediately after surgery and at 2, 4, 8 and 12 weeks post-implantation. Ultrasonographic examinations were carried out every 2 weeks after implantation up to 12 weeks using ultrasound machine (TOSHIBA Capasee II) connected with 7MHz frequency transducer. The sheep were euthanased at 2, 4, 8, and 12 weeks post-implantation and the bone examined grossly. Both ultrasonographs and radiographs taken at 8 and 12 weeks showed that the implants had been resorbed and left the space that much reduced in size. There was no sign of implant rejection observed in all animals. The results showed that processed coral has potential to become bone substitute for reconstructive bone surgery.

Absorbable Implants↗
PubMed2006

The ultrastructure and processing properties of Straumann Bone Ceramic and NanoBone.

The ultrastructure, fundamental chemistry, and processing modes of fully synthetic bone grafting materials are relevant to the reconstruction of osseous defects. Rapid progress in the profitable market of biomaterials has led to the development of various bone substitutes. Despite all these efforts, an ideal and full substitute of autologous bone is not yet in sight. With regard to anorganic calcium phosphate ceramics, Straumann Bone Ceramic and NanoBone are compared. These have a similar composition and are osteoconductive, which indispensably requires contact with well-vascularised bone.

Bone Substitutes↗
PubMed2005

Dimensional stability of the alveolar ridge after implantation of a bioabsorbable bone graft substitute: a radiographic and histomorphometric study in rats.

This study evaluated reconstruction of the alveolar ridge after molar extraction in rats with bioabsorbable bone repair scaffolds. The material was prepared from the unsaturated polyester poly(propylene glycol-co-fumaric acid) (PPF), which may be cured in situ to form a porous scaffold. The intention is to use this material either as a stand-alone bone graft substitute or as an extender to autograft harvested from mandibular reconstruction sites. The bioactivity of the graft substitute was investigated in a rat residual ridge resorption model. PPF bone repair material was injected into the defect site, where it cross-linked in situ in the presence of a hydroxyapatite (HA) filler and effervescent agents. The PPF-based material develops porosity during an in situ cure by generating carbon dioxide during the effervescent reaction of citric acid and sodium bicarbonate. The incorporation of HA promotes osteoconduction within the bone repair scaffold. In this study, bioactivity of the porous scaffold was evaluated as a function of HA particle size (micrometer-sized vs nanometer-sized particles). The maxillary or mandibular molars on the right side were extracted from 96 adult Sprague-Dawley rats. A 2-mm round bur was used to create a uniform trench defect measuring 2 mm in diameter, 2 mm in depth, and 4 mm in length at each extraction site. The defect site was (1) treated with PPF bone repair material containing nanometer-sized HA, (2) treated with PPF material containing micrometer-sized HA, (3) treated with demineralized freeze-dried bone allograft, or (4) left untreated. Rats were sacrificed at 2, 4, 7, and 12 weeks postoperative. Resorption of the residual alveolar ridge was assessed by radiographic outcomes. Bone ingrowth through the defect site was measured by histomorphometric outcomes. Mandibular and maxillary ridge heights increased for all treatments used in this study. There were no clinical indications that addition of either of the PPF bone repair materials retarded hard- or soft-tissue healing of the extraction sites. Although not statistically significant, the mandibular defects treated with PPF containing nanometer-sized HA healed at a faster rate as determined by ridge height and new bone formation measurements when compared with the other treatments. These findings suggest the feasibility of using PPF bone graft substitutes for oral-maxillofacial applications.

Absorbable Implants↗
PubMed2002

The ultrastructure of anorganic bovine bone and selected synthetic hyroxyapatites used as bone graft substitute materials.

The objective of this study was to investigate the morphology and organization of apatite crystallites in mature mammalian bone. Anorganic bovine bone was studied in this investigation to allow for the examination of the mineral crystallites after removal of the organic phase. Field-emission low-voltage scanning electron microscopy (FE-LVSEM) was employed to obtain images at nanometer resolution without the application of a conductive coating. Transmission electron microscopy (TEM) of the samples was also performed to confirm the identification of features observed in the SEM and to allow for comparison with earlier studies of bone mineral architecture. For comparison, in order to demonstrate how the interaction of collagen and apatite results in the architecture and crystal structure of bone mineral, two synthetic hydroxyapatite materials were also analyzed: OsteoGen and OsteoGraf/LD300. FE-LVSEM revealed distinctive features of bone mineral: a fibrillar organization of crystallites, a periodic spacing of crystallites along the fibrils consistent with the banding pattern of collagen, inter-fibrillar bridging crystallites, and a plate-like habit of the crystallites. These findings supported the hypothesis, derived from the earlier TEM data of others, that the mineralization of collagen comprising osteoid proceeds by the formation of apatite crystallites within the fibers at selected periodic sites along their length. Moreover, the very presence in this anorganic material of distinct fibers comprised of the crystallites is demonstration of inter-crystallite bonding. The crystallites of the synthetic hydroxyapatite materials did not display any of these ultrastructural features.

Animals↗
PubMedDate not supplied

Bone graft substitutes.

A better understanding of the biology of fracture healing and an increasing awareness of the limitations and potential complications of autogenous bone graft harvest have combined to foster a burgeoning interest in the development of bone graft substitutes. A few of these materials have been available for more than a decade, and many more should become available in the near future. The characteristics of the ideal bone graft substitute may vary considerably depending on the intended site of application and the clinical setting in which it is used. Knowledge of the available alternatives is a necessary prerequisite to informed decision making.

Bone Substitutes↗
PubMed1994

Glassy carbon implant as a bone graft substitute: an experimental study on rabbits.

The purpose of this experimental investigation was to study the incorporation of porous glassy carbon in bone. Cylinders of porous glassy carbon were implanted in drill holes in diaphyses and metaphyses of rabbits tibia for 1, 3, 6, 12 and 24 weeks. Bone ingrowth into the glassy carbon implants was examined by radiographic, histologic, fluorocrome and microradiographic methods. The material caused no pathological reaction. Tissue ingrowth into pores was seen by all examination methods. The amount of bone in the pores increases with time. The ingrowth was most distinctive in those areas where the implant was in close contact with cortical bone or trabeculae of the cancellous bone. Porous glassy carbon can be used as bone substitute, although the small size of implant available is at the present a limitation for its clinical use.

Animals↗
PubMed2003

Response of a calcium sulfate bone graft substitute in a confined cancellous defect.

Calcium sulfate, plaster of Paris, has a long clinical history for use as a bone graft substitute in various skeletal sites. The current authors examined the in vivo response of calcium sulfate pellets alone or in combination with autogenous bone graft in a bilateral critical-size distal femoral cancellous defect in an adult sheep model. New thick bone formation was seen in defects filled with calcium sulfate pellets alone. Increased immunostaining for bone morphogenetic protein-2, bone morphogenetic protein-7, transforming growth factor-beta, and platelet derived growth factor was seen in defects filled with calcium sulfate pellets alone and in combination with autograft. The local acidity during calcium sulfate resorption is proposed as a possible in vivo mechanism for this type of material.

Animals↗
PubMed2006

Critical considerations on the diagnostic appraisal, adaptation and remodelling of bone graft substitutes.

The diagnostic assessment of skeletal defects has a long-standing tradition. As a result of the development of new bone grafting materials, the demands on diagnostic assessment have also increased. The mode and quality of diagnostic appraisal are crucial to further clinical use and outcome prediction. Alongside traditional clinical and biological techniques, molecular biological methods have gained a broad scope of application and will be used even more frequently in the future.

Bone Substitutes↗
PubMed2006

Wound management after the application of bone grafting substitutes in the orofacial region.

Surgical dressing after the application of bone grafting material depends on the type and size of the defect. A complete and tension-free wound closure has proved to be successful. In this context the infection problem needs special attention. Bone graft substitutes with an adequate surface structure, porosity and chemical properties, in combination with sufficient blood circulation, hold osteoconductive potential. They serve as a guide rail for the osteoblast-induced formation of new bone tissue, which at best may lead to complete replacement of the grafting material.

Alveolar Ridge Augmentation↗
PubMed2002

Use of bone graft substitutes in lower extremity reconstructive surgery.

Autologous iliac crest graft has been a standard source of supplementary bone for treating bony defects, fractures and arthrodeses. Bone graft substitutes have recently become widely available. This paper reports on the use of bone graft substitute in 28 patients that otherwise would have required an iliac crest graft. Twenty-four of the 28 operations were successful in the primary procedure with four patients requiring a second procedure that was then successful.

Adolescent↗
PubMed2005

Calvarial bone response to a tricalcium phosphate-genipin crosslinked gelatin composite.

A biodegradable composite which was composed of genipin cross-linked gelatin mixing with tricalcium phosphate ceramic particles (GGT) was developed as a bone substitute. This study was evaluated by the biological response of rabbit calvarial bone to assess the potential of the GGT composite as a biodegradable and osteoconductive bone substitute. Eighteen New Zealand white rabbits were used for cranial implantation. Bone defects (15 x 15 mm) of nine rabbits were filled with the GGT composites, while the others were filled with the de-proteinized bovine bones as controls. Three rabbits were examined for each group in every time period at 4, 8 and 12 weeks post-surgery. The assessment included serial post-operative gross examinations, radiographic analyses and histological evaluations. This study demonstrated that this composite is: (1) malleable, with easily molded to the calvarial bone defect without fracture; (2) biocompatible, with no evidence of adverse tissue reaction; (3) osteoconductive, with progressive growth of new bone into the calvarial bone defect; (4) biodegradable, with progressive replacement of the composite by new bone. Additionally, results of both radiographic analyses and histological evaluations revealed obviously greater new bone ingrowth in the GGT composite compared with the de-proteinized bovine bone at the same implantation time. Therefore, the GGT composite could serve as a useful bone substitute for repairing bone defects.

Animals↗
PubMed2002

Natural coral exoskeleton as a bone graft substitute: a review.

Natural coral graft substitutes are derived from the exoskeleton of marine madreporic corals. Researchers first started evaluating corals as potential bone graft substitutes in the early 1970s in animals and in 1979 in humans. The structure of the commonly used coral, Porites, is similar to that of cancellous bone and its initial mechanical properties resemble those of bone. The exoskeleton of these high content calcium carbonate scaffolds has since been shown to be biocompatible, osteoconductive, and biodegradable at variable rates depending on the exoskeleton porosity, the implantation site and the species. Although not osteoinductive or osteogenic, coral grafts act as an adequate carrier for growth factors and allow cell attachment, growth, spreading and differentiation. When applied appropriately and when selected to match the resorption rate with the bone formation rate of the implantation site, natural coral exoskeletons have been found to be impressive bone graft substitutes. The purpose of this article is to review and summarize all the pertinent work that has been published on natural coral as a bone graft including in vitro, animal and clinical human studies. Preliminary report of our own experiments as well as our recommendations on the use of coral are also included.

Animals↗
PubMed2004

In vitro study of osteogenic differentiation of bone marrow stromal cells on heat-treated porcine trabecular bone blocks.

This in vitro study investigated the potential of the heat-treated porcine trabecular bone block as a bone substitute for the treatment of bone defects or related diseases. Chemical, mechanical, and morphological studies of bone blocks were performed. The resultant properties were compared with the properties of currently available commercial products from bovine trabecular bones. The major component of the bone block was hydroxyapatite, and the ratio of Ca/P was 1.65-1.66. The average values of the compressive Young's modulus and the ultimate strength were 346.33 +/- 83.15 and 6.66 +/- 1.62 MPa, respectively. The pore size of the heat-treated bone blocks was approximately 300-500 microm. For the biological investigations, expanded bone marrow stromal cells (BMSCs) were isolated from the femurs of New Zealand White rabbits and were dynamically seeded into the heat-treated porcine bone block (10x10x5 mm3). Before the cells were seeded, the heat-treated porcine bone blocks were divided into two groups: collagen coated blocks (n=16) and uncoated blocks (n=16). Within each group, the blocks were again divided into two groups, depending on the culture method, i.e., static or rotating culture. Cells were cultured in the blocks for up to 6 weeks. Scanning electron microscopic examination after 4 weeks showed that the cell layers attached to the porcine bone block. Proliferation and osteogenic differentiation were analyzed by cell counting, an MTT assay, alkaline phosphatase activity, and total protein content. The deposition of extracellular substances and osteoid formation surrounded by osteoblast-like cuboidal cells were confirmed through histochemical staining and transmission electron microscopy. Based on the results of this study, we conclude that heat-treated porcine trabecular bone has great potential as a bone substitute and may even be superior to currently available commercial products.

Animals↗
PubMed2004

[Reconstruction [correction to Reconstrction] of mandibular bone defects by using the techniques [correction to teachniques] of the reverse engineering and rapid prototyping].

OBJECTIVE: To evaluate the feasibility of designing and fabricating customized titanium bone substitutes to restore mandibular bone defects using reverse engineering (RE) and rapid prototyping (RP) techniques. METHODS: Titanium tray for mandibular defects were designed and fabricated through multi-step procedures of reverse engineering and rapid prototyping, then in operation it was filled with cancellous bone and fixed. RESULTS: The bone substitutes fabricated by this method had been successfully put into clinical use for maxillofacial surgery in 2 patients and got a satisfactory result. CONCLUSIONS: Reverse engineering combining with rapid prototyping could accomplish the design and manufacture of implant for the restoration of mandibular bone defects.

Adult↗