A review: In vivo studies of bioceramics as bone substitute materials (original) (raw)

New Approach to Bone Tissue Engineering: Simultaneous Application of Hydroxyapatite and Bioactive Glass Coated on a Poly( l -lactic acid) Scaffold

ACS Applied Materials & Interfaces, 2011

A combination of bioceramics and polymeric nanofibers holds promising potential for bone tissue engineering applications. In the present study, hydroxyapatite (HA), bioactive glass (BG), and tricalcium phosphate (TCP) particles were coated on the surface of electrospun poly(L-lactic acid) (PLLA) nanofibers, and the capacity of the PLLA, BGÀPLLA, HAÀPLLA, HAÀBGÀPLLA, and TCPÀPLLA scaffolds for bone regeneration was investigated in rat critical-size defects using digital mammography, multislice spiral-computed tomography (MSCT) imaging, and histological analysis. Electrospun scaffolds exhibited a nanofibrous structure with a homogeneous distribution of bioceramics along the surface of PLLA nanofibers. A total of 8 weeks after implantation, no sign of complication or inflammation was observed at the site of the calvarial bone defect. On the basis of imaging analysis, a higher level of bone reconstruction was observed in the animals receiving HA-, BG-, and TCP-coated scaffolds compared to an untreated control group. In addition, simultaneous coating of HA and BG induced the highest regeneration among all groups. Histological staining confirmed these findings and also showed an efficient osseointegration in HAÀBG-coated nanofibers. On the whole, it was demonstrated that nanofibrous structures could serve as an appropriate support to guide the healing process, and coating their surface with bioceramics enhanced bone reconstruction. These bioceramic-coated scaffolds can be used as new bone-graft substitutes capable of efficiently inducing osteoconduction and osseointegration in orthopedic fractures and defects.

A glass-reinforced hydroxyapatite and surgical-grade calcium sulfate for bone regeneration: In vivo biological behavior in a sheep model

A glass-reinforced hydroxyapatite (HA) composite (Bonelike®) was developed for bone grafting. This biomaterial is composed of a modified HA matrix with α- and β-tricalcium phosphate secondary phases, resulting in higher solubility than single HA type of materials. Several in vitro and in vivo studies demonstrated that Bonelike® has a highly bioactive behavior, which was also confirmed by employing granular forms of this biomaterial in orthopedics and dental applications. However, a fast consolidation vehicle was needed to promote the fixation of Bonelike® granules if applied in larger defects or in unstable sites. Surgical-grade calcium sulfate (CS), which is widely recognized as a well-tolerated and inexpensive bone graft material, was the chosen vehicle to improve the handling characteristics of Bonelike® as it can be used in the form of a powder that is mixed with a liquid to form a paste that sets in situ. After application in non-critical monocortical defects in sheep, histological, and scanning electron microscopy evaluations demonstrated that Bonelike® associated to CS functioned as a very satisfactory scaffold for bone regeneration as it achieved synchronization of the ingrowing bone with biomaterial resorption and subsequent preservation of the bone graft initial volume. Therefore, our results indicate that CS is an effective vehicle for Bonelike® granules as it facilitates their application and does not interfere with their proven highly osteoconductive properties. In the opposite way, the incorporation of Bonelike® improves the bone regeneration capabilities of CS.

A comparison between the efficacy of Bio-Oss, hydroxyapatite tricalcium phosphate and combination of mesenchymal stem cells in inducing bone regeneration

Biomedical Journal, 2012

Background: Recently, tissue engineering has been introduced as a regenerative treatment for bone defects. There is some evidence showing bone regeneration from mesenchymal stem cells (MSC) loaded on hydroxyapatite β-tricalcium phosphate (HA/TCP) as a scaffold in large defects. This study aimed to compare the quality and quantity of regenerated bone using Bio-Oss, HA/TCP and MSC loaded HA/TCP scaffolds. Methods: Mesenchymal stem cells were aspirated from iliac crest bone marrow after extracting the first, second and third premolars and the first molar in five mature hybrid dogs. The cells were cultured and their osteogenic differentiation potential was evaluated after the third cell passage using Alizarin red staining in experimental conditions. The HA/TCP scaffold (3 x 3 x 3 mm) was loaded with undifferentiated mesenchymal stem cells. Bilateral bone defects were then prepared in the jaws using trephine burs. The defects were randomly filled with HA/TCP, Bio-Oss, or HA/TCP + MSCs. One defect served as a control and was left as an empty cavity. All defects except the control defect were covered with an absorbable membrane. Histological and histomorphometric evaluations were conducted after 6 weeks and data were subjected to analysis of variance (ANOVA) (p < 0.05). Results: The empty cavity demonstrated more bone formation (60.80%) than the HA/TCP (44.93%) and Bio-Oss (40.60%) (p < 0.05) groups. However, the difference from the HA/TCP + MSCs group was not significant (46.38%) (p > 0.05). Conclusion: An MSC-loaded HA/TCP scaffold is a more effective alternative than Bio-OSS or HA/TCP in inducing bone regeneration.

Bioceramic Bone Scaffolds for Tissue Engineering

2010

Tissue engineering is a new field that made rapid advances. Tissue engineering eliminates reoperations by using biological substitutes that allow native cells to grow. Scaffolds and its properties play important role for success of this technique. Porous calcium phosphate ceramics (mainly hydroxyapatite (HA) and tricalcium phosphate (TCP)) with interconnected macro-pores (~ 100 to 500 μm) as well as high porosities (~ 80%) were prepared by a new method at different temperatures giving a scaffold could be used in different situations. we present a simple, direct lithographic method to fabricate this scaffold. In order to improve the mechanical properties such as compressive strength and compressive modulus and maintain the desirable bioactivity carboxymethyl-celleulose (CMC) is added forming a composite structure. The CMC made the porous calcium phosphate ceramics proved to be bioactive and exhibited compressive strengths up to 18MPa and compressive modules up to 6 GPa which were comparable to those of natural bones. The obtained complex porous bioactive/ biodegradable composites could be used as tissue engineering scaffolds for high load bearing applications. This composite scaffold can be satisfied with the basic requirement for tissue engineering, and has the potential to be applied in repair and substitute of human menisci of the knee-joint and articular cartilage.

Bioceramics and bone healing

EFORT Open Reviews

Calcium phosphates have long been used as synthetic bone grafts. Recent studies have shown that the modulation of composition and textural properties, such as nano-, micro- and macro-porosity, is a powerful strategy to control and synchronize material resorption and bone formation. Biomimetic calcium phosphates, which closely mimic the composition and structure of bone mineral, can be produced using low-temperature processing routes, and offer the possibility to modulate the material properties to a larger extent than conventional high temperature sintering processes. Advanced technologies open up new possibilities in the design of bioceramics for bone regeneration; 3D-printing technologies, in combination with the development of hybrid materials with enhanced mechanical properties, supported by finite element modelling tools, are expected to enable the design and fabrication of mechanically competent patient-specific bone grafts. The association of ions, drugs and cells allows leve...

Evaluation of Bone Repair in the Mandible of Rabbits Using Biphasic Calcium Phosphate Micro-Macroporous Hydroxyapatite Bioceramics and Beta-Tricalcium Phosphate

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

Objective: To perform a clinical and histological evaluation, characterizing and proving the feasibility of the use of beta tricalcium phosphate (HA/βTCP) bioceramics as a bone defect repair material, comparing it with autogenous bone and blood clot in terms of osteoinductive, conductive, and genic capacities. Material and Methods: The experiment was based on 3 critical defects in the mandible of 11 New Zealand rabbits. The defects were filled with HA/βTCP bioceramics and autogenous bone, respectively, collected and ground during the development of defects and blood clots. The animals were euthanized after the 90-day experiment and samples were collected for histomorphological examination. To evaluate differences between the groups, a one-way analysis of variance (ANOVA) was performed with Tukey's post hoc test. An α value lower than 0.05 was considered statistically significant. Results: Microscopy revealed the presence of osteoblasts, osteoclasts, and osteocytes associated or not associated with the presence of mature or immature bone. All the studied materials presented bone neoformation in all cases, with the presence of mature and immature bone. Regarding the presence of HA/βTCP bioceramic residual material, the same was found in 7 of 11 slides. Conclusion: HA/βTCP bioceramics were shown to be a biocompatible bone substitute, with osteoinductive and osteoconductive characteristics, accelerating the process of new bone formation when compared with autogenous and blood clotted bone, thereby showing promise for bone defect repair with safety and efficacy.

Bone Remodeling, Biomaterials and Technological Applications: Revisiting Basic Concepts

2011

Presently, several different graft materials are employed in regenerative or corrective bone surgery. However current misconceptions about these biomaterials, their use and risks may compromise their correct application and development. To unveil these misconceptions, this work briefly reviewed concepts about bone remodeling, grafts classification and manufacturing processes, with a special focus on calcium phosphate materials as an example of a current employed biomaterial. Thus a search on the last decade was performed in Medline, LILACS, Scielo and other scientific electronic libraries using as keywords biomaterials, bone remodeling, regeneration, biocompatible materials, hydroxyapatite and therapeutic risks. Our search showed not only an accelerated biotechnological development that brought significant advances to biomaterials use on bone remodeling treatments but also several therapeutic risks that should not be ignored. The biomaterials specificity and limitations to clinical application point to the current need for developing safer products with better interactions with the biological microenvironments.

In Vivo Bone Formation Within Engineered Hydroxyapatite Scaffolds in a Sheep Model

Calcified Tissue International, 2016

Large bone defects still represent a major burden in orthopedics, requiring bone-graft implantation to promote the bone repair. Along with autografts that currently represent the gold standard for complicated fracture repair, the bone tissue engineering offers a promising alternative strategy combining bone-graft substitutes with osteoprogenitor cells able to support the bone tissue ingrowth within the implant. Hence, the optimization of cell loading and distribution within osteoconductive scaffolds is mandatory to support a successful bone formation within the scaffold pores. With this purpose, we engineered constructs by seeding and culturing autologous, osteodifferentiated bone marrow mesenchymal stem cells within hydroxyapatite (HA)-based grafts by means of a perfusion bioreactor to enhance the in vivo implant-bone osseointegration in an ovine model. Specifically, we compared the engineered constructs in two different anatomical bone sites, tibia, and femur, compared with cell-free or static cell-loaded scaffolds. After 2 and 4 months, the bone formation and the scaffold osseointegration were assessed by micro-CT and histological analyses. The results demonstrated the capability of the acellular HA-based grafts to determine an implant-bone osseointegration similar to that of statically or dynamically cultured grafts. Our study demonstrated that the tibia is characterized by a lower bone repair capability compared to femur, in which the contribution of transplanted cells is not crucial to enhance the bone-implant osseointegration. Indeed, only in tibia, the dynamic cell-loaded implants performed slightly better than the cell-free or static cell-loaded grafts, indicating that this is a valid approach to sustain the bone deposition and osseointegration in disadvantaged anatomical sites. Keywords Bone graft Á Ovine model Á Tibia Á Femur Á Mesenchymal stem cells Á Dynamic culture S. Lopa and C. Recordati have contributed equally to this work.

Tissue engineering of bone: search for a better scaffold

Orthodontics and Craniofacial Research, 2005

Structured Abstract Authors -Mastrogiacomo M, Muraglia A, Komlev V, Peyrin F, Rustichelli F, Crovace A, Cancedda R Background -Large bone defects still represent a major problem in orthopedics. Traditional bone-repair treatments can be divided into two groups: the bone transport (Ilizarov technology) and the graft transplant (autologous or allogeneic bone grafts). Thus far, none of these strategies have proven to be always resolving. As an alternative, a tissue engineering approach has been proposed where osteogenic cells, bioceramic scaffolds, growth factors and physical forces concur to the bone defect repair. Different sources of osteoprogenitor cells have been suggested, bone marrow stromal cells (BMSC) being in most cases the first choice. Methods and Results -In association with mineral tridimensional scaffolds, BMSC form a primary bone tissue which is highly vascularized and colonized by host hemopoietic marrow. The chemical composition of the scaffold is crucial for the osteoconductive properties and the resorbability of the material. In addition, scaffolds should have an internal structure permissive for vascular invasion. Porous bioceramics [hydroxyapatite (HA) and tricalcium phosphate] are osteoconductive and are particularly advantageous for bone tissue engineering application as they induce neither an immune nor an inflammatory response in the implanted host.

Comparative in vitro study of four commercial biomaterials used for bone grafting

Journal of Applied Biomaterials & Functional Materials, 2013

Even if autogenous bone still remains the gold standard to augment or bridge osseous defects, bone substitute materials of natural (natural-derived materials and biological materials) or of synthetic origin are becoming increasingly used to avoid the risks associated with autogenous bone graft (peri-operative risks, specific operative complications and post-operative morbidity).