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Comparison of tissue reactions in the tracheal mucosa surrounding a bioabsorbable and silicone airway stents.

BACKGROUND: Treatment of tracheobronchial stenosis is problematic. Conservative methods include stenting the stenotic area, but an ideal stent has not yet been developed. Bioabsorbable airway stents offer benefits; the extraction of the device is unnecessary, and the airway preserves its normal function after stent resorption. The aim of this study was to examine the suitability of self-reinforced poly-L-lactide as a material for an airway stent. METHODS: A spiral airway stent made of 0.7-mm wire of self-reinforced poly-L-lactide was implanted operatively in 9 rabbits intratracheally; silicone stents served as controls. RESULTS: Silicone stents had a tendency to become stenosed with encrustation material and to develop a hyperplastic polyp at both ends. Self-reinforced poly-L-lactide stents were well tolerated and caused no foreign body reaction, and they had a tendency to penetrate into the tracheal wall. They had disappeared at the end of the follow-up of 10 months. CONCLUSIONS: This experimental study showed that bioabsorbable self-reinforced poly-L-lactide is a promising material for an airway stent for treatment of airway stenosis.

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Tacks: a new technique for craniofacial fixation.

Biodegradable fixation in craniofacial surgery provides secure fixation while eliminating much of the concern over intracranial migration of metallic plates and screws. One limitation of present biodegradable systems, however, is the need for tapping the drill hole before screw insertion. Herein, a new method of rigid, biodegradable fixation with tacks (Macrapore, Inc., San Diego, CA) is described. The tacks are made of a 70:30 ratio of the L and DL form of polylactic acid (L,DL-PLA). Degradation times range from 18 to 36 months. Newer prototypes are nearly developed for more rapid dissolution times. From April 1999 to February 2000, tack fixation has been applied in 100 patients (51 males, 49 females aged 3 months to 61 years). Indications for operation were craniosynostosis (n = 33); craniofacial trauma or post-traumatic deformities (n = 11); cleft lip and palate (n = 13); craniofacial syndromes (n = 18); other diagnoses (n = 11). Patients underwent fronto-orbital advancement with cranial reshaping; monobloc osteotomy, open reduction-internal fixation of fractures; hypertelorbitism repair; cranioplasty; stabilization of grafts; major cranial reconstruction; zygomatic advancement; alveolar cleft repair; and iliac bone graft donor site protection. Tacks were also used for temporalis muscle and lateral canthal suspension. Follow-up ranged from 16 to 28 months. Complications occurred in 7 patients, 4 of whom had infections and during debridement had biodegradable implants removed. None of the complications appeared to be related to the use of tacks. The tacks are carried in a specially designed holder and may be placed by hand or with the light tap of a mallet on the tack driver. An automatic driver has been developed. Overall, the performance of the tacks has been excellent. They are easily handled by the nursing personnel and rapidly inserted by the surgeon. Stability appears to be excellent. At this time, it is probably preferable to employ tap and screws for orthognathic surgery or other osteotomies with substantial load bearing.

Absorbable Implants↗

Tendon chitosan tubes covalently coupled with synthesized laminin peptides facilitate nerve regeneration in vivo.

We have developed tendon chitosan tubes having the ability to bind peptides covalently, and the effectiveness of laminin peptides coupled to these tubular wall on nerve regeneration was examined in vivo. Bridge graft implantation (15 mm) into the sciatic nerve of SD rats was carried out using chitosan tubes having a triangular cross section containing either covalently bound intact laminin or the laminin peptides CDPGYIGSR or CSRARKQAASIKVAVSAD or being nontreated (N = 20 in each group). As a control, isografting (N = 5) was carried out. Three rats in each experimental group were sacrificed for histology observations after 1, 2, 4, 6, and 8 weeks. The total area of regenerating tissue in the tube and the length of the area where regenerating tissue attached to the inner surface of the tube were measured. In five rats from each experimental and control group, the latency quotient between the implanted and the nontreated site was determined 12 weeks after implantation. Furthermore, the percentage of myelinated axon area was measured at a 10-mm distance from the distal anastomosed site. Histological findings suggest that the immobilized laminin, confirmed by immunostaining as long as 12 weeks postoperatively, as well as laminin oligopeptides may effectively assist nerve tissue extension. According to statistical analysis of the percentage neural tissue found in relation to evoked action potentials, the sequential treatments with YIGSR first followed by IKVAV matched the effectiveness of intact laminin in enhancing nerve regeneration. However, when compared with that after isografting, the enhancement of regenerated axon growth was less sufficient.

Absorbable Implants↗

Tissue engineering of a small hand phalanx with a porously casted polylactic acid-polyglycolic acid copolymer.

In this study, we evaluate a porous polylactic acid-polyglycolic acid (PLGA) polymer in tissue engineering a small hand phalanx. The PLGA polymer was processed with a unique solvent cast/salt-leaching method in the shape of a little finger distal phalanx. An 85% polylactic acid (PLA)/15% polyglycolic acid (PGA) copolymer was determined to be the most favorable mixture for creating a small digital phalanx in precise shape and size. The pore sizes averaged 250-425 microm. Bovine periosteum was wrapped around each phalangeal polymer. Chondrocytes were injected into the articular end. Six constructs were surgically placed into a dorsal subcutaneous pocket of an ethylic mouse. After 8 (n=2) or 16 (n = 4) weeks, all implants demonstrated growth of bone and cartilage in the shape and size of a small hand phalanx, which was maintained throughout the study period. Histologic evaluation showed a homogeneous presence of bone and cartilage, with progressive tissue differentiation and matrix production from 8 to 16 weeks. The tissue-engineered bone formed through an endochondral ossification process. Articular cartilage was maintained where the chondrocytes were placed. These findings suggest that the porous PLGA polymer is an effective synthetic biodegradable device to support and guide tissue growth of bone and articular cartilage in the shape of a human phalanx.

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[Tissue engineered bone reconstruction with modified PLGA/Type-I collagen compound scaffold].

OBJECTIVE: To fabricate bone grafts by bone marrow stromal cell combined with modified PLGA/Type-I collagen compound scaffold using tissue engineering method. METHODS: The modified PLGA/Type-I collagen compound scaffold was fabricated. The rabbit primary cultured osteoblasts were identified and seeded onto the modified compound scaffold for one week in vitro. The adhesion and growth of cells were observed with scanning electron microscope. The complex of cells and scaffold was implanted into the subcutaneous region of rabbits and new bone formation was evaluated. RESULTS: The rabbit bone marrow stromal cells were induced and differentiated into osteoblasts. The adhesion and growth of osteoblasts in cluster were observed on the surface of scaffolds. New bone formation was observed at one month postoperatively and active osteoblasts were found on the surface of the newly formed bone in vivo. CONCLUSION: The complex of PLGA and type-I collagen is an appropriate biodegradable scaffold and can be applied in bone tissue engineering.

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Novel synthetic selectively degradable vascular prostheses: a preliminary implantation study.

BACKGROUND: Vascular grafts perform less well than autologous arterial or vein grafts. The purpose of this study was to evaluate the short-term performance of selectively biodegradable filament-wound vascular prostheses, comprising elastomeric poly(ether urethane) (Lycra) scaffolds and flexible, hydrophilic biodegradable coatings. MATERIALS AND METHODS: Two types of selectively biodegradable vascular grafts were manufactured, comprising a filament-wound Lycra scaffold, subsequently coated with a biodegradable poly(ethylene glycol)/poly(lactic acid) (PELA) block copolymer. The two types of grafts differed in both the overall porosity of the scaffold and the hydrophilicity of the biodegradable constituent. A 60-mm-long and 6-mm-diameter filament-wound and polytetrafluoroethylene (ePTFE) grafts were implanted as interposition prostheses, randomly, at the right- and left-side carotid arteries. RESULTS: Implantation studies proved the grafts to be patent and pulsatile for periods of up to 3 months. Increasing the scaffold porosity and enhancing the hydrophilicity of the biodegradable component improved both the transmural tissue ingrowth process and the vascularization of the prosthesis wall. Also, a well-adhered peripheral tissue and a thin, uniform intima and endothelial lining were obtained. All ePTFE graft controls, although patent, were rather stiff and nonpulsatile. A thick pseudointima, poorly attached to the prosthesis inner surface, was observed. The compliance of the wet grafts was significantly higher than in the dry state, stemming mainly from the water-plasticizing effect on the biodegradable component. The grafts explanted after a period of 6 weeks exhibited compliance only slightly lower than that of the wet grafts. After 12 weeks, however, the hoop compliance was 20% lower than that prior to implantation. At 100 mm Hg, for example, the original compliance of the wet graft was 2.5%/100 mm Hg decreasing to 2.0%/100 mm Hg after a 3-month implantation. The compliance reduction with implantation is attributed to the ingrowth of the perigraft tissue as revealed by the histological study. A compliance of 2.0%/100 mm Hg is slightly better than that of a standard PTFE graft with an original compliance of 1.6%/100 mm Hg. Yet it is still an order of magnitude smaller than that of a canine carotid artery. CONCLUSIONS: The improved mechanical properties and enhanced healing of the highly porous filament-wound Lycra scaffold graft coated with hydrophilic biodegradable PELA has the potential of being a highly effective small caliber prosthetic graft.

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[Reconstruction of tumor induced defects in head and neck surgery with individualized prefabricated three dimensional flaps with the use of continuous vacuum therapy].

Despite recent developments in oncologic head and neck surgery extensive tissue and functional defects following radical tumor resections remains a surgical challenge. Individually prefabricated free flaps to meet the needs of the functional defect can be generated with the help of continuous computer-assisted vacuum therapy. This accelerates the pre-fabrication of three-dimensional composite flaps and enhances therapeutic safety. Changes of the genuine structure of such flaps are induced by implantation of autologous or heterologous transplants alone or in combination with alloplastic materials as a supportive element. Application of vacuum therapy is useful to accelerate the process of pre-fabrication by the induction of angiogenesis. Besides this the continuous removal of wound exudate, possible seroma or haematoma and secondary compression of the different tissue layers improve the modelling of the three-dimensional construct. This article describes the technique of vacuum therapy for the pre-fabrication of three-dimensional pedicled or free flaps for reconstruction of defects after tumor resection in the head and neck area.

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Effects of Runx2 genetic engineering and in vitro maturation of tissue-engineered constructs on the repair of critical size bone defects.

Genetic and tissue engineering strategies are being pursued to address the clinical limitations of current bone grafting materials. Based on our previous work demonstrating that overexpression of the Runx2 osteoblastic transcription factor and in vitro construct maturation synergistically enhanced in vivo mineralization in an ectopic site (Byers et al., Tissue Eng 2004;10:1757-1766), we examined the effects of these two parameters on the repair of critical size bone defects. Primary rat bone marrow stromal cells transduced with Runx2 or control (no Runx2 insert) retroviral vector were seeded onto 3D fused deposition-modeled polycaprolactone scaffolds. Runx2-modified cells produced biologically-equivalent mineralized matrices at nearly 2-fold higher rates than control cells. Constructs cultured in vitro for 1 day (immature) or 21 days (mineralized) were subsequently implanted into critical size calvaria defects in syngeneic rats, and bone healing was analyzed by micro-CT and histomorphometry at 28 days. Runx2-modified and control constructs precultured for 1 day healed to a greater extent than defects receiving no implant. Cell-free scaffolds yielded equivalent levels of bone formation as constructs precultured for 1 day. Interestingly, defects treated with control cell-seeded constructs precultured for 21 days exhibited low bone formation compared to other construct treatments, and repair was comparable to empty defects. In contrast, Runx2-modified constructs precultured for 21 days contained twice as much bone as control constructs precultured for 21 days and equivalent levels of new bone as cell-free and 1 day precultured constructs. These results demonstrate interplay between Runx2 genetically-modified cells and in vitro construct maturation in bone healing responses.

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New scaffold for recombinant human bone morphogenetic protein-2.

A bioactive and resorbable scaffold is necessary to exhibit the osteoinductive potency of recombinant human bone morphogenetic protein-2 (rhBMP-2). In a previous study, we found that synthetic octacalcium phosphate (OCP) enhances bone regeneration and is replaced by newly formed bone after it is resorbed. We hypothesized that OCP may be useful as an effective scaffold for rhBMP-2 to enhance bone regeneration. To test this hypothesis, the present study was designed to investigate whether an OCP/BMP composite implant could more effectively enhance bone regeneration. A critical-sized defect was made in a rat calvarium and 1. 15 mg of OCP combined with 10 microg of rhBMP-2 (OCP/BMP 10 microg), 2. 15 mg of OCP combined with 1 microg of rhBMP-2 (OCP/BMP 1 microg), or 3. OCP (OCP alone) was implanted into the defect and fixed at 4 or 8 weeks after implantation. The percentage of newly formed bone (n-Bone%) in the defect was determined by a histomorphometrical analysis. A statistical analysis showed that n-Bone% with OCP/BMP was significantly higher than that with OCP at both time points, whereas the difference in n-Bone% between OCP/BMP 10 microg and OCP/BMP 1 microg was not significant. The present results suggest that OCP can be used as an effective scaffold for rhBMP-2 and this OCP delivery system may be able to reduce the standard effective dose of rhBMP-2, which would be beneficial because low doses (<100 microg/g OCP) of rhBMP-2 enhance bone regeneration.

Absorbable Implants↗

[Arthroscopic meniscal repair with bioresorbable implants].

OBJECTIVE: Restoration of the shape and function of a torn meniscus. INDICATIONS: Complete or large incomplete longitudinal tear of the medial and lateral meniscus close to the base, large flap tear, so-called bucket-handle tear. CONTRAINDICATIONS: Degenerative meniscal tissue. Unstable knee joint without concomitant surgical stabilization. Complex meniscal tear or radial tear. Tear in the central avascular region. Gonarthrosis. Joint infection. Local skin disorders. SURGICAL TECHNIQUE: Visualization of the meniscal tear and revitalization of the tear margins with a meniscal rasp or shaver. Introduction of the implant using the surgical technique required and repair of the tear. Percutaneous trepanation of the meniscal base ("needling") to improve healing. POSTOPERATIVE MANAGEMENT: Full weight bearing only with the knee joint extended in an orthosis until after the 6th postoperative week. Knee flexion up to 30 degrees without weight bearing for the first 2 postoperative weeks with physiotherapy, then up to 60 degrees for another 4 weeks. Short movable knee orthosis with 0-0-90 degrees in the 7th-12th postoperative week. After the 12th postoperative week, continuation of physiotherapy without orthosis, until range of movement has been achieved and the knee-stabilizing muscles have regained their strength. Full sporting capacity after 6 months. RESULTS: The healing rate for meniscal repair with bioresorbable implants is between 86% and 95% and is comparable with the average healing rate for open (84-88%) or arthroscopic suture techniques (98%). Between July 1999 and June 2001, a meniscal tear was treated with Clearfix screws in 65 patients. 60 patients (92%) had a follow-up examination on average 18 months postoperatively. Six patients underwent further arthroscopic surgery as a result of pain (four times healed, twice not healed). Another three patients complained of pain on weight bearing at the follow-up examination and had clinically positive meniscus signs. These patients were then evaluated as "treatment failures". The clinical healing rate was therefore 92% (55 out of 60).

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Macroscopical, histological, and morphometric studies of porous bone-replacement materials in minipigs 8 months after implantation.

OBJECTIVE: The aim of this investigation was to test the induction of bone formation and biodegradation of different biomaterials based on calcium phosphate (CaP). Up to now, hydroxyapatite and beta-tricalcium phosphate ceramics have routinely been sintered at temperatures of 1300 degrees C. The new CaP biomaterials tested are fabricated by a sol-gel process at only 700 degrees C. STUDY DESIGN: Critical-size defects (>5 cm(3)) in the mandible of 15 adult Goettingen minipigs were filled with 1 of the 2 new types of CaP biomaterials, or with 1 of 2 well-known old-type ceramics, or with a gelatin sponge (in the control group). Macroscopical, histological, and morphometric examination of the former defect areas were made 8 months postoperatively. RESULTS: Eight months after implantation of the new CaP biomaterials, complete bone formation was observed in the defect area, and at the same time, the foreign material was resorbed almost completely. After implantation of the classical types of ceramics, only incomplete bone formation and a lesser resorption rate of the foreign bodies were noted. The difference in the bone formation rate was significant: more than 93% for the new CaP biomaterials versus less than 58% for the classical types of ceramics (P < 0.01). CONCLUSION: The biological behavior of the new CaP biomaterials was better than that of the old-type sintered ceramic bone-grafting materials. These new CaP matrices are suitable for filling bone defects and are of interest for dentists, including implantologists, craniomaxillofacial and orthopedic surgeons, as well as traumatologists.

Absorbable Implants↗

Long-lasting bioresorbable poly(lactic acid) (PLA94) mesh: a new approach for soft tissue reinforcement based on an experimental pilot study.

The purpose of this study was to evaluate host response and soft-tissue regeneration after poly(lactic acid) (PLA) mesh implantation in a rat model, in comparison with light-weight polypropylene (PPL) and poly(glycolic acid) (PGA) meshes. Full-thickness abdominal wall defects were created in 45 Wistar rats and reconstructed with 15 PLA(94), 15 PPL and 15 PGA meshes. Animals were killed on days 7, 30 and 90 to evaluate the presence of adhesions and changes in tensile strength of the implants. Histopathology and immunohistochemistry were performed to evaluate the collagen deposition and the inflammatory response. Statistics were done using unpaired Student's t-test, Mann-Whitney rank sum test, Student-Newman-Keuls test and Bonferroni (Dunn) t-test. The inflammatory response induced by the PLA mesh implantation was significantly milder than after PPL mesh. In PLA, vascularity and collagen organization was significantly higher than in PPL and PGA at 30 and 90 days, and collagen composition score was significantly higher than in PPL at 7 and 30 days. In PLA, shrinkage was significantly lower than in PPL and PGA at 7 and 30 days. Elongation at break and tensile strength were comparable between PLA and PPL over the 90-day period. The PLA mesh induces a milder inflammatory response, more orderly collagen deposition than PPL, and preserved comparable tensile strength after 90 days.

Abdominal Wall↗

The use of bioabsorbable implants in the spine.

BACKGROUND CONTEXT: Bioabsorbable implants are commonplace in sports medicine surgeries, especially in shoulder and knee ligamentous reconstruction. Their use is now expanding to the realm of spinal reconstructive surgery. Newer polymers offer reduced incidence of the side effects of aseptic sterile sinus formation and have appropriate resorption time parameters for spine use. These new bioabsorbable materials confer initial and intermediate-term stability that is adequate for stable bony healing in various applications. The majority of human clinical applications in the spine that have been documented involve bone graft harvest site reconstruction, posterior spinal graft containment, anterior interbody reconstruction and anterior cervical and lumbar spine tension band plating. PURPOSE: The purpose of this review article is to highlight the indications and outcomes of the use of bioabsorbable implants in specific spinal applications. STUDY DESIGN: A comprehensive literature review of the English and non-English literature on bioabsorbable implant technology. METHODS: A comprehensive literature review was performed to gather basic science, animal and human data on the use of bioabsorbable implants in spinal surgery. RESULTS: Bioabsorbable implants have demonstrated strength and resorption characteristics commensurate with the physiologic and biomechanical requirements of the human spinal axis. Histologic sampling has demonstrated successful time-patterned resorption accompanied by bony replacement and remodeling of intervertebral cage devices in the animal model. CONCLUSION: Bioresorbable compounds appear to have a role in specific spinal reconstructive procedures. Their radiolucent nature improves image assessment of fusion healing, and their time-engineered resorption characteristics allow controlled dynamization in interbody and plate applications. Their widespread use and acceptance may increase dramatically as further research and clinical studies report on their safety and efficacy.

Absorbable Implants↗

[MRI in ACL reconstructive surgery with PDLLA bioabsorbable interference screws: evaluation of degradation and osteointegration processes of bioabsorbable screws].

PURPOSE: Anterior cruciate ligament (ACL) reconstructive surgery has seen significant progress since bioabsorbable interference screws have replaced synthetic metallic screws for ligament graft fixation within the femoral and tibial osseous tunnel. Our study compared the MR images of patients who underwent ACL reconstruction using bioabsorbable interference screws with those of patients who underwent ACL reconstruction using metallic screws to evaluate the MR aspects of degradation and osteointegration processes of bioabsorbable interference screws post-operatively. MATERIALS AND METHODS: Between September 1999 and December 2002 we performed MRI on 40 patients who underwent arthroscopic ACL reconstruction with patellar tendon auto-graft using PDLLA bioabsorbable screws in 35 cases and metallic screws in 5 cases. After surgery, all patients underwent an intensive rehabilitation programme along with clinical evaluation using the standard knee ligament evaluation form of the International Knee Documentation Committee (IKDC) and radiological examinations. MR studies were performed 1, 2 and 3 years post-operatively using a 0.5-Tesla MR scanner with T1- and T2*-weighted and STIR sequences. RESULTS: Thirty-three patients were clinically classified as group A IKDC (full return to sports activity) and 7 patients as group B IKDC. No foreign-body reaction was found in patients treated with bioabsorbable interference screws, both from a clinical point of view and from laboratory exams. Ferromagnetic artefacts were found in all patients treated with metallic interference screws. In patients with bioabsorbable interference screws, degradation of the screws and absence of significant artefacts allowed correct evaluation of the signal of the reconstructed ligament throughout its length, the osseous tunnels and the joint cavity. In 34 of 35 patients with bioabsorbable interference screws, the screw could not be detected due to complete degradation. In 8, 12 and 4 cases, a small cyst-like formation due to screw hydrolysis was present at the screw site within 1, 2 and 3 years from surgery respectively. Only in 4 cases was the process of osteointegration of the screw and bone plug complete 3 years after the operation, with consequent restoration of bone morphology. DISCUSSION AND CONCLUSIONS: The use of bioabsorbable interference screws is a valuable alternative to synthetic metallic fixation implants as the absence of artefacts allows correct post-operative MR follow-up. MRI is the only technique able to visualize all the portions of the transplant and to evaluate the healing process. Bioabsorbable interference screws usually degrade within one year. However, full osteointegration requires a long time and may not be complete 3 years after surgery. The presence of cyst-like formations at the screw site has to be regarded as a normal feature of the screw degradation process. Therefore, the use of bioabsorbable interference screws is recommended as it enables MR follow-up of the knee after ACL reconstruction.

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Image analysis of the axonal ingrowth into poly(D,L-lactide) porous scaffolds in relation to the 3-D porous structure.

Porous polymer scaffolds are promising materials for neural tissue engineering because they offer valuable three-dimensional (3-D) supports for the in vitro and in vivo axonal growth and tissue expansion. At the time being, how the in vivo neuronal cell development depends on the scaffold 3-D architecture is unknown. Therefore, scanning electron micrographs of longitudinal sections of porous polylactide scaffolds and immunohistological sections of these scaffolds after implantation and neurofilament staining have been studied by image analysis. Pore orientation and axonal ingrowth have been investigated by spectral analysis on gray level SEM images. Binary image processing has been carried out and the binary images have been studied by spectral analysis in order to estimate the possible effect of the image noise on the real pattern. In addition to axonal orientation, density and length distribution of the regenerated axons into the polymer scaffold have been measured. Dependence of the axonal ingrowth on the 3D-polymer scaffold has been discussed on the basis of the collected data.

Absorbable Implants↗

An introduction to biodegradable materials for tissue engineering applications.

Tissue generation by autogenous cell transplantation is one of the most promising treatment concepts being developed as it eliminates problems of donor site scarcity, immune rejection and pathogen transfer. Cultured cells are seeded onto a three-dimensional biocompatible scaffold that will slowly degrade and resorb as the soft and hard structures grow and assimilate in vitro and/or in vivo. The 3-D scaffold provides the necessary template for cells to proliferate and maintain their differentiated state. Ultimately, it defines the overall shape of the tissue-engineered transplant. The aim of this review is to describe and discuss the scaffold materials of natural and synthetic origin that are of specific interest to tissue engineers. This review is based on previous publications and our own experience in the use of biomaterials of natural and synthetic origin for tissue engineering applications. Biodegradable polymers which have been used for tissue engineering applications are mainly based on clinically established medical devices and implants. In the group of macromolecules of natural origin collagen, alginate, agarose, hyaluronic acid derivatives, chitosan, and fibrin glue have been used as scaffolds. Man-made polymers such as polyglycolide (PGA), polylactides (PLLA, PDLA), poly(caprolactone) (PCL), and poly(dioxanone) (PDS) have been studied as matrix material to guide the differentiation and proliferation of cells into the targeted functional premature and/or mature tissue. Appropriate selection of scaffold material with respect to the targeted tissue is essential. Today, biomaterials of choice remain to be those approved by the US Food and Drug Administration. In spite of that, novel biomaterials should be developed specifically designed for tissue engineering applications.

Absorbable Implants↗

The role of androgens in the trade-off between territorial and parental behavior in the Azorean rock-pool blenny, Parablennius parvicornis.

Androgen hormones have been shown to facilitate competitive ability in courtship and territorial behavior, while suppressing paternal behavior. The rock-pool blenny, Parablennius parvicornis, provides an excellent model to study the proximate regulation of such a trade-off between territorial and parental behavior, because nest-holder males of this species display these behaviors simultaneously. A field study was carried out in which territorial nest holder males were either treated with long-lasting implants filled with 11-ketotestosterone (11-KT) or with control implants. Males treated with 11-KT showed a higher frequency of aggressive behavior, were more responsive to aggressive challenges, and were more persistent in aggressive behavior than control males. In addition, territories were larger in males treated with 11-KT than in controls. We found evidence for incompatibility between defense of a large territory and high levels of parental behavior. However, contrary to expectation, 11-KT did not suppress parental behavior. We suggest that trade-offs between territorial and parental behavior may not be regulated by androgen hormones but may result from a time constraint in the individual's activity budget.

Absorbable Implants↗

Histologic effect of pure-phase beta-tricalcium phosphate on bone regeneration in human artificial jawbone defects.

The effect of the pure-phase beta-tricalcium phosphate (beta-TCP) Cerasorb on bone regeneration was evaluated in hollow titanium cylinders implanted in the posterior jaws of five volunteers. Beta-TCP particles were inserted inside the cylinders and harvested 6 months after placement. The density of the newly formed bone inside the bone-growing chambers measured 27.84% +/- 24.67% in test and 17.90% +/- 4.28% in control subjects, without a statistically significant difference. Analysis of the histologic specimens revealed that the density of the regenerated bone was related to the density of the surrounding bone. The present study demonstrates the spontaneous healing of infrabony artificial defects, 2.5 mm diameter, in the jaw. The pure beta-TCP was resorbed simultaneously with new bone formation, without interference with the bone matrix formation.

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