Spinal fusion using autologous bone graft is performed in an increasing rate for many spinal disorders. However, graft harvesting procedure is associated with prolonged operation time and potential donor site morbidity. We produced an engineered 'bone graft' substitute by using porous hydroxyapatite (HA) scaffold seeded with autologous bone marrow osteoprogenitor cells (OPCs) and fibrin. This obviates bone graft harvesting, thus eliminates donor site morbidity and shortens the operation time. The aim of this study is to evaluate Hydroxyapatite (HA) ceramics as scaffold for autologous tissue engineered bone construct for spinal fusion in a sheep model. The sheep's marrow was aspirated from iliac crest. The bone marrow mesenchymal stem cells (BMMSCs) were cultured for several passages in the presence of growth and differentiation factors to increase the number of OPCs. After the cultures reached confluence, they were trypsinized and seeded on Hydroxyapatite scaffold (HA). Approximately 5 million cells were generated after 3 weeks of culture. Microscopically, very tight Colony Forming Units (CFU-Fs) were seen on monolayer culture. The Von Kossa and Alizarin Red staining of monolayer culture showed positive mineralization areas; indicating the presence of OPCs. Sheep underwent a posterolateral spinal fusion in which scaffolds with or without OPCs seeded were implanted on both sides of the lumbar spine (L1-L2). Intended fusion segments were immobilized using wires. At the end of third month, the fusion constructs were harvested for histological examination. Fibrous tissue infiltration found in the inter-connecting pores of plain HA ceramics indicates inefficient new bone regeneration. New bone was found surrounding the HA ceramics seeded with autologous cells. The new bone is probably formed by the sheep BMMSCs that were initially encapsulating HA while it remained intact. The new bone is naturally fused with the vertebrae. In conclusion, the incorporation of autologous bone marrow cells improved the effectiveness of HA ceramics as 'bone graft' substitute for spinal fusion.
Metallic materials implanted into bone defects are generally encapsulated by a fibrous tissue. Some metallic materials such as titanium and tantalum, however, have been revealed to bond to the living bone without forming the fibrous tissue, when they were subjected to NaOH solution and heat treatments. Thus treated metals form bone tissue around them even in muscle, when they take a porous form. This kind of osteoconductive and osteoinductive properties are attributed to sodium titanate or tantalate layer on their surfaces formed by the NaOH and heat treatments. These layers induce the deposition of bonelike apatite on the surface of the metals in the living body. This kind of bioactive metals are useful as bone substitutes even highly loaded portions, such as hip joint, spine and tooth root.
Matched MeSH terms: Bone Substitutes/chemical synthesis*
Avian demineralized bone matrix (ADBM) powder prepared from chicken, pigeon, and turkey sources induced bone formation via endochondral and intramembranous processes, as in mammalian studies. There were no significant differences in percentage of new bone, percentage of cartilage, surface-forming osteoblast area, or osteoclast count between gaps treated with chicken, pigeon, and turkey DBM. However, there was a significantly (p<0.05) higher percentage of inflammatory area in gaps treated with chicken DBM than in gaps treated with pigeon DBM.
This study is to qualitatively evaluate a locally produced hydroxyapatite (HA), made by AMREC-SIRIM in an experimental animal bone defect using New Zealand White (NZW) rabbits. HA cylindrical blocks measuring 2.5 mm (D) x 1.0 mm (H) were implanted in the rabbits' left tibia. The tibias were harvested within one to three weeks post-implantation. The implantion site was cut into thin undecalcified sections of about 30 microm to 60 microm and stained with Toluidine Blue and Goldner's Masson Trichrome. Microscopic examinations using standard light microscopy of these slides were performed.
Hydroxyapatite is a calcium phosphate bioceramic that has been shown by many authors to be biocompatible with bioactive properties. It is widely accepted as the best synthetic material available for surgical use as a bone graft substitute. HA granules produced by AMREC-SIRIM from local materials underwent 5 types of sterilisation techniques with different ageing periods. Samples were tested for chemical and phase composition and microbial contamination before and after being sterilised. From the microbiological tests done, none of the unsterilised positive control yielded a positive culture. Results from X-Ray diffraction studies found that all the sterilisation techniques did not chemically degrade or structurally change the HA granules significantly.
The purpose of the study was to evaluate radiologically the efficacy of guided bone regeneration using composite bone graft (autogenous bone graft and anorganic bovine bone graft [Bio-Oss]) along with resorbable collagen membrane (BioMend Extend) in the augmentation of Seibert's class I ridge defects in maxilla. Bone width was evaluated using computerized tomography at day 0 and at day 180 at 2 mm, 4 mm, and 6 mm from the crest. There was a statistically significant increase in bone width between day 0 and day 180 at 2 mm, 4 mm, and 6 mm from the crest. The results of the study demonstrated an increase in bone width of Seibert's class I ridge defects in the maxilla of the study patients.
We conducted a prospective study in order to audit our experience of repairing cranial defects using Methyl methacrylate. This included a total of 49 patients undergoing cranioplasty using methyl methacrylate, of which 45 were males and 4 females. The age of patients at the time of surgery ranged from 16 to 40 years old, with an average of 24 years. Malays were the majority (67%), followed by Chinese (23%) and Indian (10%). Cranial defects were mainly caused by motor vehicle accident (94%), while gunshot wounds, industrial accidents and tumours, each contribute 2%. Bone flaps were commonly removed during previous surgery related to traumatic subdural haemorrhage (33%), contusion (21%) and intracerebral haemorrhage (14%). The size of cranial defects ranged from 28 cm2 to 440 cm2, with an average of 201 cm2. Most had right sided (55%) and lateral defects [temporoparietal (52%) followed by temporal (16%), frontal (16%), frontotemporal (14%) and occipital (2%)]. Duration of surgery ranged from 70 to 275 minutes, with an average of 135 minutes. Nine of 12 patients (75%) with neurological disability had some improvement while 85% of symptomatic patients had symptoms improvement after cranioplasty. The infection rate in this series was 4%.
Matched MeSH terms: Bone Substitutes/therapeutic use*; Bone Substitutes/chemistry
Hydroxyapatite is a biocompatible material that is extensively used in the replacement and regeneration of bone material. In nature, nanostructured hydroxyapatite is the main component present in hard body tissues. Hence, the state of the art in nanotechnology can be exploited to synthesize nanophase hydroxyapatite that has similar properties with natural hydroxyapatite. Sustainable methods to mass-produce synthetic hydroxyapatite nanoparticles are being developed to meet the increasing demand for these materials and to further develop the progress made in hard tissue regeneration, especially for orthopedic and dental applications. This article reviews the current developments in nanophase hydroxyapatite through various manufacturing techniques and modifications.
Essential oils play an important role in reducing the pain and inflammation caused by bone fracture.In this study, a scaffold was electrospun based on polyurethane (PU), grape seed oil, honey and propolis for bone tissue-engineering applications. The fiber diameter of the electrospun PU/grape seed oil scaffold and PU/grape seed oil/honey/propolis scaffold were observed to be reduced compared to the pristine PU control. FTIR analysis revealed the existence of grape seed oil, honey and propolis in PU identified by CH band peak shift and also hydrogen bond formation. The contact angle of PU/grape seed oil scaffold was found to increase owing to hydrophobic nature and the contact angle for the PU/grape seed/honey oil/propolis scaffold were decreased because of hydrophilic nature. Further, the prepared PU/grape seed oil and PU/grape seed oil/honey/propolis scaffold showed enhanced thermal stability and reduction in surface roughness than the control as revealed in thermogravimetric analysis (TGA) and atomic force microscopy (AFM) analysis. Further, the developed nanocomposite scaffold displayed delayed blood clotting time than the pristine PU in the activated prothrombin time (APTT) and partial thromboplastin time (PT) assay. The hemolytic assay and cytocompatibility studies revealed that the electrospun PU/grape seed oil and PU/grape seed oil/honey/propolis scaffold possess non-toxic behaviour to red blood cells (RBC) and human fibroblast cells (HDF) cells indicating better blood compatibility and cell viability rates. Hence, the newly developed electrospun nanofibrous composite scaffold with desirable characteristics might be used as an alternative candidate for bone tissue engineering applications.
Matched MeSH terms: Bone Substitutes/toxicity; Bone Substitutes/chemistry*
Hydroxyapatite is the main component of the bone which is a potential biomaterial substance that can be applied in orthopaedics. In this study, the biocompatibility of this biomaterial was assessed using an in vitro technique. The cytotoxicity and genotoxicity effect of HA2 and HA3 against L929 fibroblast cell was evaluated using the MTT Assay and Alkaline Comet Assay respectively. Both HA2 and HA3 compound showed low cytotoxicity effect as determined using MTT Assay. Cells viability following 72 hours incubation at maximum concentration of both HA2 and HA3 (200 mg/ml) were 75.3 +/- 8.8% and 86.7 +/- 13.1% respectively. However, the cytotoxicity effect of ZnSO4.7H2O as a positive control showed an IC50 values of 46 mg/ml (160 microM). On the other hand, both HA2 and HA3 compound showed a slight genotoxicity effect as determined using the Alkaline Comet Assay following incubation at the concentration 200 mg/ml for 72 hours. This assay has been widely used in genetic toxicology to detect DNA strand breaks and alkali-labile site. The percentage of the cells with DNA damage for both substance was 27.7 +/- 1.3% and 15.6 +/- 1.0% for HA2 and HA3 respectively. Incubation of the cells for 24 hours with 38 microg/ml (IC25) of positive control showed an increase in percentage of cells with DNA damage (67.5 +/- 0.7%). In conclusion, our study indicated that both hydroxyapatite compounds showed a good biocompatibility in fibroblast cells.
Calcium phosphate-based bone substitutes have not been used to repair load-bearing bone defects due to their weak mechanical property. In this study, we reevaluated the functional outcomes of combining ceramic block with osteogenic-induced mesenchymal stem cells and platelet-rich plasma (TEB) to repair critical-sized segmental tibial defect. Comparisons were made with fresh marrow-impregnated ceramic block (MIC) and partially demineralized allogeneic bone block (ALLO). Six New Zealand White female rabbits were used in each study group and three rabbits with no implants were used as negative controls. By Day 90, 4/6 rabbits in TEB group and 2/6 in ALLO and MIC groups resumed normal gait pattern. Union was achieved significantly faster in TEB group with a radiological score of 4.50 ± 0.78 versus ALLO (1.06 ± 0.32), MIC (1.28 ± 0.24), and negative controls (0). Histologically, TEB group scored the highest percentage of new bone (82% ± 5.1%) compared to ALLO (5% ± 2.5%) and MIC (26% ± 5.2%). Biomechanically, TEB-treated tibiae achieved the highest compressive strength (43.50 ± 12.72 MPa) compared to those treated with ALLO (15.15 ± 3.57 MPa) and MIC (23.28 ± 6.14 MPa). In conclusion, TEB can repair critical-sized segmental load-bearing bone defects and restore limb function.
Various materials have been used as scaffolds to suit different demands in tissue engineering. One of the most important criteria is that the scaffold must be biocompatible. This study was carried out to investigate the potential of HA or TCP/HA scaffold seeded with osteogenic induced sheep marrow cells (SMCs) for bone tissue engineering.
Porous hydroxyapatite (HAp) as a bone graft substitute was produced via gas technique with three different concentrations of hydrogen peroxide (H2O2) namely 20, 30 and 50%. Hydroxyapatite(HA) slurries with different concentration were produced by mixing between H2O2 solutions and HA powder (L/P) with different ratio i.e. 0.9 to 2.20 ml.g-1. Different L/P ratio and H2O2 concentration affected the porosity, interconnectivity and compressive strength of HAp sample. Changes in L/P ratio between 0.9 to 2.20 ml.g-1, increases the porosity around 50 - 65% at 20% H2O2 concentration. Porosity increases with the L/P values and H2O2 concentration which 76% of porosity was obtained at 50% H2O2 and 2.20 mlg-1 of L/P. The compressive strength of HAp is in the range of 0.5 to 2.15 MPa and is found decreasing with the increasing of L/P values.
The paper discusses the influence of sintering temperature on the microstructure and strength of hydroxyapatite ceramics prepared using the extrusion process. The average pore diameters observed were in the range of approximately 150mm to 300mm whereas the compaction strength was found to be around 120-160 MPa.
Matched MeSH terms: Bone Substitutes/analysis*; Bone Substitutes/chemical synthesis
Hydroxyapatite (HAp) is an attractive bioceramics due to its similar composition to bone mineral and its ability to promote bone-implant interaction. However, its low strength has limited its application as load bearing implants. This paper presented a work focusing on the improvement of HAp mechanical property by synthesizing iron (Fe)-reinforced bovine HAp nanocomposite powders via mechanosynthesis method. The synthesis process was performed using high energy milling at varied milling time (3, 6, 9, and 12h). The samples were characterized by X-ray diffraction (XRD), Fourier transform infrared (FT-IR), and scanning electron microscopy (SEM). Its mechanical properties were investigated by micro-Vicker's hardness and compression tests. Results showed that milling time directly influenced the characteristics of the nanocomposite powders. Amorphous BHAp was formed after 9 and 12h milling in the presence of HPO4(2-) ions. Continuous milling has improved the crystallinity of Fe without changing the HAp lattice structure. The nanocomposite powders were found in spherical shape, agglomerated and dense after longer milling time. The hardness and Young's modulus of the nanocomposites were also increased at 69% and 66%, respectively, as the milling time was prolonged from 3 to 12h. Therefore, the improvement of the mechanical properties of nanocomposite was attributed to high Fe crystallinity and homogenous, dense structure produced by mechanosynthesis.
Matched MeSH terms: Bone Substitutes/chemical synthesis*
Many attempts have been focused in the past on preparing of synthetic E-tricalcium (E-TCP), which being employed as bone substitute due to its biocompatibility and resorbability. Low temperature synthesize such as sol-gel method become popular due to the high product purity and homogenous composition. Sol-gel method is less economical towards commercialization because the cost of raw materials and the yield of the product that can be achieved. This paper describes the synthesis of ETCP via mixing of CaCO3 and H3PO4 followed by calcinations process at 750qC – 1050qC. X-ray diffraction (XRD), scanning electron microscopy (SEM), differential scanning calorimeter (DSC), fourier transformation infra-red (FTIR) were used for characterization and evaluation of the phase composition, morphology, particle size and thermal behavior of the product. E-TCP phase start to occur after calcinations at 750qC.
There has been, and is still, concern about the high elastic modulus of Ti alloys compared to bone. Any reduction in the Young's modulus value of the implant is expected to enhance stress redistribution to the adjacent bone tissues, minimize stress shielding and eventually prolong device lifetime. Dynamic Monte Carlo simulation is used to predict the gradual reduction in Young's modulus values between the bulk of Ti alloys and the modified surface layers due to Ca ion implantation. The simulation can be used as a screening step when applying new alloys and/or coatings.
The standard bioglass composition GS45 as well as with excess silica GS50 or with the addition of 5% titanium oxide GS45+Ti5, were prepared by the polymeric route. The different glass components were added to the formed polymer. Firing at 700 degrees C gave an amorphous product with microporous texture that readily crystallizes out at 900 degrees C. The prepared materials were highly porous with two modes of pore system micro-pores and macro-pores with a size ranging between 100 microm to 0.006 microm and a porosity reaching 73%. The measured bulk density was between 0.36 to 1.1g/cm3. The fired material preserved the former structure of the polymer precursor. Biocompatibility was verified in vitro and vivo. IR of the specimens previously immersed in SBF revealed the formation of apatite like layer. While the histology sections of implants in rate femurs showed new bone tissue or bone trabeculae after 21 days.
Matched MeSH terms: Bone Substitutes/chemical synthesis*