Hydroxyapatite/beta-tricalcium phosphate and enamel matrix derivative for treatment of proximal class II furcation defects: a randomized clinical trial

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The effect of BMP-2 on the osteoconductive properties of beta-tricalcium phosphate in rat calvaria defects

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Osteoconductive Properties of beta-Tricalcium Phosphate Matrix, Polylactic and Polyglycolic Acid Gel, and Calcium Phosphate Cement in Bone Defects

Extensive bone defects in maxillofacial region can be corrected with autogenous grafts; otherwise, the disadvantages of the therapeutics modality take the research for new bone substitutes. The aim of the study was to evaluate and compare the osteoconductive properties of 3 commercial available biomaterials. A total of 30 calvarial defects (5-mm diameter) were randomly divided into 5 treatment groups, with a total of 6 defects per treatment group (n = 6). The treatment groups were as follows: 500 to 1000 Km beta-tricalcium phosphate (beta-TCP), polylactic and polyglycolic acid (PL/PG) gel, calcium phosphate cement, untreated control, and autograft control. The evaluations were based on histomorphometric analysis at 60 postoperative days. The results have shown that beta-TCP and autograft control supported bone formation at 60 postoperative days. beta-Tricalcium phosphate showed the highest amount of mineralized area per total area and statistically significant compared with PL/PG, calcium phosphate cement, and untreated control groups. The PL/PG gel does not have osteoconductive properties and performed similar to empty control. Calcium phosphate cement showed higher number of multinucleated giant cells around the sites of the biomaterial and showed newly formed bone only at the edges of the biomaterial, without bone formation within the biomaterial. The findings presented herein indicate that bone formation reached a maximum level when rat calvarial defects were filled with beta-TCP at 60 postoperative days. Further studies should be conducted with beta-TCP to understand the potential of this biomaterial in bone regeneration.

Use of autogenous bone and beta-tricalcium phosphate in maxillary sinus lifting: a prospective, randomized, volumetric computed tomography study

The correction of bone defects can be performed using autogenous or alloplastic materials, such as beta-tricalcium phosphate (β-TCP). This study compared the changes in bone volume (CBV) after maxillary sinus lifting using autogenous bone (n=12), autogenous bone associated with β-TCP 1:1 (ChronOS; DePuy Synthes, Paoli, CA, USA) (n=9), and β-TCP alone (n=11) as grafting material, by means of cone beam computed tomography (CBCT). CBV was evaluated by comparing CBCT scans obtained in the immediate postoperative period (5-7 days) and at 6 months postoperative in each group using OsiriX software (OsiriX Foundation, Geneva, Switzerland). The results showed an average resorption of 45.7±18.6% for the autogenous bone group, 43.8±18.4% for the autogenous bone+β-TCP group, and 38.3±16.6% for the β-TCP group. All bone substitute materials tested in this study presented satisfactory results for maxillary sinus lifting procedures regarding the maintenance of graft volume during the healing phase before the insertion of implants, as assessed by means of CBCT.

Clinical and histologic evaluation of granular Beta-tricalcium phosphate for the treatment of human intrabony periodontal defects: a report on five cases

BACKGROUND: The aim of the study is to clinically and histologically evaluate the healing of advanced intrabony defects treated with open flap debridement and the adjunct implantation of granular beta tricalcium phosphate (beta-TCP). METHODS: Five patients, each displaying advanced combined 1- and 2-wall intrabony defects around teeth scheduled for extraction or root resection, were recruited. Approximately 6 months after surgery, the teeth or roots were removed together with a portion of their surrounding soft and hard tissues and processed for histologic evaluation. RESULTS: The mean probing depth (PD) was reduced from 10.8 +/- 2.3 mm presurgically to 4.6 +/- 2.1 mm, whereas a mean clinical attachment level (CAL) gain of 5.0 +/- 0.7 mm was observed. The increase in gingival recession was 1.2 +/- 3.2 mm. The histologic evaluation indicated the formation of new cellular cementum with inserting collagen fibers to a varying extent (mean: 1.9 +/- 0.7 mm; range: 1.2 to 3.03 mm) coronal to the most apical extent of the root instrumentation. The mean new bone formation was 1.0 +/- 0.7 mm (range: 0.0 to 1.9 mm). In most specimens, beta-TCP particles were embedded in the connective tissue, whereas the formation of a mineralized bone-like or cementum-like tissue around the particles was only occasionally observed. CONCLUSION: The present data indicates that treatment of intrabony periodontal defects with this beta-TCP may result in substantial clinical improvements such as PD reduction and CAL gain, but this beta-TCP does not seem to enhance the regeneration of cementum, periodontal ligament, and bone.

Bone healing and graft resorption of autograft, anorganic bovine bone and beta-tricalcium phosphate. A histologic and histomorphometric study in the mandibles of minipigs

OBJECTIVE: The purpose was to qualitatively and quantitatively compare the bone formation and graft resorption of two different bone substitutes used in both orthopedic and oral surgery, with autogenous bone as a positive control. MATERIALS AND METHODS: Three standardized bone defects were prepared in both mandibular angles of 12 adult minipigs. The defects were grafted with either autograft, anorganic bovine bone (ABB), or synthetic beta-tricalcium phosphate (beta-TCP). Sacrifice was performed after 1, 2, 4, and 8 weeks for histologic and histomorphometric analysis. RESULTS: At 2 weeks, more new bone formation was seen in defects filled with autograft than with ABB (P approximately 0.0005) and beta-TCP (P approximately 0.002). After 4 weeks, there was no significant difference between beta-TCP and the two other materials. Defects grafted with ABB still exhibited less bone formation as compared with autograft (P approximately 0.004). At 8 weeks, more bone formation was observed in defects grafted with autograft (P approximately 0.003) and beta-TCP (P approximately 0.00004) than with ABB. No difference could be demonstrated between beta-TCP and autograft. beta-TCP resorbed almost completely over 8 weeks, whereas ABB remained stable. CONCLUSION: Both bone substitutes seemed to decelerate bone regeneration in the early healing phase as compared with autograft. All defects ultimately regenerated with newly formed bone and a developing bone marrow. The grafting materials showed complete osseous integration. Both bone substitutes may have a place in reconstructive surgery where different clinical indications require differences in biodegradability.

Effect of solvent; enhancing the wettability and engineering the porous structure of a calcium phosphate/agarose composite for drug delivery

Tissue engineering deals with the regeneration of tissues for bone repair, wound healing, drug delivery, etc., and a highly porous 3D artificial scaffold is required to accommodate the cells and direct their growth. We prepared 3D porous calcium phosphate ((hydroxyapatite/beta-tricalcium phosphate)/agarose, (HAp/beta-TCP)/agarose) composite scaffolds by sol-gel technique with water (WBS) and ethanol (EBS) as solvents. The crystalline phases of HAp and beta-TCP in the scaffolds were confirmed by X-ray diffraction (XRD) analysis. The EBS had reduced crystallinity and crystallite size compared to WBS. WBS and EBS revealed interconnected pores of 1 mu m and 100 nm, respectively. The swelling ratio was higher for EBS in water and phosphate buffered saline (PBS). An in vitro drug loading/release experiment was carried out on the scaffolds using gentamicin sulphate (GS) and amoxicillin (AMX). We observed initial burst release followed by sustained release from WBS and EBS. In addition, GS showed more extended release than AMX from both the scaffolds. GS and AMX loaded scaffolds showed greater efficacy against Pseudomonas than Bacillus species. WBS exhibited enhanced mechanical properties, wettability, drug loading and haemocompatibility compared to EBS. In vitro cell studies showed that over the scaffolds, MC3T3 cells attached and proliferated and there was a significant increase in live MC3T3 cells. Both scaffolds supported MC3T3 proliferation and mineralization in the absence of osteogenic differentiation supplements in media which proves the scaffolds are osteoconducive. Microporous scaffolds (WBS) could assist the bone in-growth, whereas the presence of nanopores (EBS) could enhance the degradation process. Hence, WBS and EBS could be used as scaffolds for tissue engineering and drug delivery. This is a cost effective technique to produce scaffolds of degradable 3D ceramic-polymer composites.

Development and microwave characterization of selected biocompatible materials and conducting polymers

The 20th century witnessed the extensive use of microwaves in industrial, scientific and medical fields. The major hindrance to many developments in the ISM field is the lack of knowledge about the effect of microwaves on materials used in various applications. The study of the interaction of microwaves with materials demanded the knowledge of the dielectric properties of these materials. However, the dielectric properties of many of these materials are still unknown or less studied. This thesis is an effort to shed light into the dielectric properties of some materials which are used in medical, scientific and industrial fields. Microwave phantoms are those materials used in microwave simulation applications. Effort has been taken to develop and characterize low cost, eco-friendly phantoms from Biomaterials and Bioceramics. The interaction of microwaves with living tissues paved way to the development of materials for electromagnetic shielding. Materials with good conductivity/absorption properties could be used for EMI shielding applications. Conducting polymer materials are developed and characterized in this context. The materials which are developed and analyzed in this thesis are Biomaterials, Bioceramics and Conducting polymers. The use of materials of biological origin in scientific and medical applications provides an eco-friendly pathway. The microwave characterization of the materials were done using cavity material perturbation method. Low cost and ecofriendly biomaterial films were developed from Arrowroot and Chitosan. The developed films could be used in applications such as microwave phantom material, capsule material in pharmaceutical applications, trans-dermal patch material and eco-friendly Band-Aids. Bioceramics with better bioresorption and biocompatibility were synthesized. Bioceramics such as Hydroxyapatite, Beta tricalcium phosphate and Biphasic Calcium Phosphate were studied. The prepared bioceramics could be used as phantom material representing Collagen, Bone marrow, Human abdominal wall fat and Human chest fat. Conducting polymers- based on Polyaniline, are developed and characterized. The developed materials can be used in electromagnetic shielding applications such as in anechoic chambers, transmission cables etc

Analysis of β-tricalcium phosphate granules prepared with different formulations by nano-computed tomography and scanning electron microscopy

International audience

In vitro testing of Advanced JAX (TM) Bone Void Filler System: species differences in the response of bone marrow stromal cells to beta tri-calcium phosphate and carboxymethylcellulose gel

The Advanced JAX (TM) Bone Void Filler System (AJBVFS) is a novel bone graft material manufactured by Smith and Nephew Orthopaedics Ltd. and comprises beta tri-calcium phosphate granules with carboxymethylcellulose (CMC) gel as a handling agent. This study investigated the potential, in vitro, of the AJBVFS to function as a delivery system for cell therapy to enhance healing of bone defects. The attachment of rabbit bone marrow stromal cells (rbBMSCs), human BMSCs (hBMSCs) and human bone-derived cells (hBDCs) to JAX (TM) granules and the effect of CMC gel on cell proliferation and differentiation were investigated. There were slight species differences in the number and morphology of cells attached on the JAX (TM) granules with less rbBMSC attachment than human. All cells tolerated the presence of CMC gel and a reduction in cell number was only seen after longer exposure to higher gel concentrations. Low concentrations of CMC gel enhanced proliferation, alkaline phosphatase (ALP) expression and ALP activity in human cells but had no effect on rbBMSC. This study suggests that AJBVFS is an appropriate scaffold for the delivery of osteogenic cells and the addition of CMC gel as a handling agent promotes osteogenic proliferation and differentiation and is therefore likely to encourage bone healing.

Printability of calcium phosphate: Calcium sulphate powders for the application of tissue engineered bone scaffolds using the 3D printing technique

In this study, calcium phosphate (CaP) powders were blended with a three-dimensional printing (3DP) calcium sulfate (CaSO4)-based powder and the resulting composite powders were printed with a water-based binder using the 3DP technology. Application of a water-based binder ensured the manufacture of CaP:CaSO4 constructs on a reliable and repeatable basis, without long term damage of the printhead. Printability of CaP:CaSO4 powders was quantitatively assessed by investigating the key 3DP process parameters, i.e. in-process powder bed packing, drop penetration behavior and the quality of printed solid constructs. Effects of particle size, CaP:CaSO4 ratio and CaP powder type on the 3DP process were considered. The drop penetration technique was used to reliably identify powder formulations that could be potentially used for the application of tissue engineered bone scaffolds using the 3DP technique. Significant improvements (p < 0.05) in the 3DP process parameters were found for CaP (30-110 μm):CaSO4 powders compared to CaP (< 20 μm):CaSO4 powders. Higher compressive strength was obtained for the powders with the higher CaP:CaSO4 ratio. Hydroxyapatite (HA):CaSO4 powders showed better results than beta-tricalcium phosphate (β-TCP):CaSO4 powders. Solid and porous constructs were manufactured using the 3DP technique from the optimized CaP:CaSO4 powder formulations. High-quality printed constructs were manufactured, which exhibited appropriate green compressive strength and a high level of printing accuracy.

Análise do processo de reparo de defeitos ósseos críticos em calvária de ratos preenchidos com osso autógeno ou Bone Ceramic: um estudo histométrico e imunoistoquímico

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Análise tomográfica, histológica, histométrica e imunoistoquímica do beta tricálcio fosfato com osso autógeno em aumento do soalho de seio maxilar

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estudo comparativo do processo de reparo utilizando osso autógeno e beta-tricálcio fosfato em levantamento do assoalho do seio maxilar em humanos: análise tomográfica, histológica, histométrica e imunoistoquímica

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

O uso do beta-tricálcio fosfato como substituto ósseo em odontologia

The correction of bone defects is the restoration of lost structures which can be replaced by alloplastic implants or bone grafts. Due to the known disadvantages of removal of autogenous grafts, most researches in dentistry aim to develop alloplastic or non-alloplastic materials able to replace bone without these limitations. Beta-Tricalcium Phosphate (β-TCP) is a synthetic granular bone substitute, biocompatible, osteoconductive, which can be used in the alveolar reconstruction. In this work, we perform a literature review on the β-TCP characteristics and discuss its application in dentistry.