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Keywords = calcium sulfate bone cement

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14 pages, 6003 KiB  
Article
Tetracalcium Phosphate/Monetite/Calcium Sulfate Hemihydrate Biocement for Alveolar Bone Augmentation After Tooth Extraction in Pig Mandible
by Katarína Vdoviaková, Lenka Krešáková, Filip Humeník, Ján Danko, Kristína Čurgali, Andrej Jenča, Andrej Jenča, Adriána Petrášová, Janka Jenčová, Marko Vrzgula, Mária Giretová, Radoslava Štulajterová and Ľubomír Medvecký
Bioengineering 2024, 11(11), 1057; https://doi.org/10.3390/bioengineering11111057 - 24 Oct 2024
Cited by 1 | Viewed by 1716
Abstract
A tetracalcium phosphate/monetite/calcium sulfate hemihydrate powder cement mixture (CAS) in the form of a paste was used as a socket preservative to prevent alveolar ridge resorption after the extraction of the second premolar tooth in the mandible of a pig model. During the [...] Read more.
A tetracalcium phosphate/monetite/calcium sulfate hemihydrate powder cement mixture (CAS) in the form of a paste was used as a socket preservative to prevent alveolar ridge resorption after the extraction of the second premolar tooth in the mandible of a pig model. During the post-surgery period, the animals were monitored daily. No signs of inflammation, infection, or other complications were observed in the defect site for six months. Six months after surgery, the mandible defects in pigs were evaluated using macroscopic, histological, and radiological techniques. Treatment of the extraction sites with CAS biocement resulted in the uniform filling of the defects with alveolar bone tissue, characterized by a relatively smooth and homogeneous gum surface with no visible biocement residues. The formation of new bone tissue with osteoblasts, osteocytes, and mineralized matrices was confirmed. The results showed the similar morphology, thickness, and complete integration of the newly formed bone with the surrounding tissue. CAS biocement could be an effective material to prevent alveolar bone reduction as well as soft tissue loss and could support dental implant placement with long-term functionality. Full article
(This article belongs to the Special Issue Biomaterials for Bone Repair and Regeneration)
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14 pages, 2159 KiB  
Article
A Bioactive Degradable Composite Bone Cement Based on Calcium Sulfate and Magnesium Polyphosphate
by Suping Peng, Xinyue Yang, Wangcai Zou, Xiaolu Chen, Hao Deng, Qiyi Zhang and Yonggang Yan
Materials 2024, 17(8), 1861; https://doi.org/10.3390/ma17081861 - 18 Apr 2024
Cited by 2 | Viewed by 2174
Abstract
Calcium sulfate bone cement (CSC) is extensively used as a bone repair material due to its ability to self-solidify, degradability, and osteogenic ability. However, the fast degradation, low mechanical strength, and insufficient biological activity limit its application. This study used magnesium polyphosphate (MPP) [...] Read more.
Calcium sulfate bone cement (CSC) is extensively used as a bone repair material due to its ability to self-solidify, degradability, and osteogenic ability. However, the fast degradation, low mechanical strength, and insufficient biological activity limit its application. This study used magnesium polyphosphate (MPP) and constructed a composite bone cement composed of calcium sulfate (CS), MPP, tricalcium silicate (C3S), and plasticizer hydroxypropyl methylcellulose (HPMC). The optimized CS/MPP/C3S composite bone cement has a suitable setting time of approximately 15.0 min, a compressive strength of 26.6 MPa, and an injectability of about 93%. The CS/MPP/C3S composite bone cement has excellent biocompatibility and osteogenic capabilities; our results showed that cell proliferation is up to 114% compared with the control after 5 days. After 14 days, the expression levels of osteogenic-related genes, including Runx2, BMP2, OCN, OPN, and COL-1, are about 1.8, 2.8, 2.5, 2.2, and 2.2 times higher than those of the control, respectively, while the alkaline phosphatase activity is about 1.7 times higher. Therefore, the CS/MPP/C3S composite bone cement overcomes the limitations of CSC and has more effective potential in bone repair. Full article
(This article belongs to the Special Issue The 15th Anniversary of Materials—Recent Advances in Biomaterials)
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17 pages, 4292 KiB  
Article
Design and Manufacture of Bone Cements Based on Calcium Sulfate Hemihydrate and Mg, Sr-Doped Bioactive Glass
by Nazanin Moazeni, Saeed Hesaraki, Aliasghar Behnamghader, Javad Esmaeilzadeh, Gorka Orive, Alireza Dolatshahi-Pirouz and Shokoufeh Borhan
Biomedicines 2023, 11(10), 2833; https://doi.org/10.3390/biomedicines11102833 - 18 Oct 2023
Cited by 6 | Viewed by 2437
Abstract
In the present study, a novel composite bone cement based on calcium sulfate hemihydrate (CSH) and Mg, Sr-containing bioactive glass (BG) as solid phase, and solution of chitosan as liquid phase were developed. The phase composition, morphology, setting time, injectability, viscosity, and cellular [...] Read more.
In the present study, a novel composite bone cement based on calcium sulfate hemihydrate (CSH) and Mg, Sr-containing bioactive glass (BG) as solid phase, and solution of chitosan as liquid phase were developed. The phase composition, morphology, setting time, injectability, viscosity, and cellular responses of the composites with various contents of BG (0, 10, 20, and 30 wt.%) were investigated. The pure calcium sulfate cement was set at approximately 180 min, whereas the setting time was drastically decreased to 6 min by replacing 30 wt.% glass powder for CSH in the cement solid phase. BG changed the microscopic morphology of the set cement and decreased the size and compaction of the precipitated gypsum phase. Replacing the CSH phase with BG increased injection force of the produced cement; however, all the cements were injected at a nearly constant force, lower than 20 N. The viscosity measurements in oscillatory mode determined the shear-thinning behavior of the pastes. Although the viscosity of the pastes increased with increasing BG content, it was influenced by the frequency extent. Pure calcium sulfate cement exhibited some transient cytotoxicity on human-derived bone mesenchymal stem cells and it was compensated by introducing BG phase. Moreover, BG improved the cell proliferation and mineralization of extracellular matrix as shown by calcein measurements. The results indicate the injectable composite cement comprising 70 wt.% CSH and 30 wt.% Mg, Sr-doped BG has better setting, mechanical and cellular behaviors and hence, is a potential candidate for bone repair, however more animal and human clinical evaluations are essential. Full article
(This article belongs to the Topic Advanced Functional Materials for Regenerative Medicine)
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15 pages, 7862 KiB  
Article
Materials in the CaO-K2O-SO3-H2O System Based on Powder Mixtures including Calciolangbeinite K2Ca2(SO4)3 and Calcium Sulfate Anhydrite CaSO4
by Alexander I. Kuznetsov, Tatiana V. Safronova, Tatiana B. Shatalova, Yaroslav Y. Filippov, Leonid A. Vaymugin, Vyacheslav S. Vlasenko and Maxim S. Likhanov
Ceramics 2023, 6(3), 1434-1448; https://doi.org/10.3390/ceramics6030088 - 5 Jul 2023
Cited by 3 | Viewed by 2247
Abstract
Materials (cement stone samples) in the CaO-K2O-SO3-H2O system with the target phase compositions, including syngenite K2Ca(SO4)2·H2O and calcium sulfate dihydrate CaSO4·2H2O, were prepared from powder [...] Read more.
Materials (cement stone samples) in the CaO-K2O-SO3-H2O system with the target phase compositions, including syngenite K2Ca(SO4)2·H2O and calcium sulfate dihydrate CaSO4·2H2O, were prepared from powder mixtures of calcium sulfate anhydrite CaSO4, and/or calciolangbeinite K2Ca2(SO4)3, and potassium sulfate K2SO4 via hydration reactions at a water/powder ratio within an interval of 0.5–0.9. It was revealed that samples with contents of 25, 50, 75 and 100 mol% of syngenite K2Ca(SO4)2·H2O demonstrated a nonlinear dependence of their respective microstructures on their phase compositions. The microstructures of samples with phase compositions of 25 and 75 mol% of syngenite K2Ca(SO4)2·H2O consisted of pillar crystals. The microstructures of samples with phase compositions of 50 and 100 mol% of syngenite K2Ca(SO4)2·H2O consisted of plate crystals. An explanation of microstructure formation was set forth, taking into account equilibria of the dissolution–crystallization processes during cement stone formation. Materials obtained in the CaO-K2O-SO3-H2O system consisting of biocompatible and resorbable (soluble in water) phases can be recommended for testing as potential substances for bone defect treatments. Full article
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24 pages, 18038 KiB  
Article
Allogenic Cancellous Bone versus Injectable Bone Substitute for Endoscopic Treatment of Simple Bone Cyst and Intraosseous Lipoma of the Calcaneus and Is Intraosseous Lipoma a Developmental Stage of a Simple Bone Cyst?
by Andreas Toepfer, Michael Strässle, Ulrich Lenze, Florian Lenze and Norbert Harrasser
J. Clin. Med. 2023, 12(13), 4272; https://doi.org/10.3390/jcm12134272 - 26 Jun 2023
Cited by 2 | Viewed by 2872
Abstract
Simple bone cysts (SBCs) and intraosseous lipoma (IOL) of the calcaneus are rare tumor entities that are primarily diagnosed due to unspecific heel pain, incidental findings, or rarely due to pathological fractures. Compared to traditional open tumor resections, endoscopic resection of these benign [...] Read more.
Simple bone cysts (SBCs) and intraosseous lipoma (IOL) of the calcaneus are rare tumor entities that are primarily diagnosed due to unspecific heel pain, incidental findings, or rarely due to pathological fractures. Compared to traditional open tumor resections, endoscopic resection of these benign tumors aims to minimize surgical morbidity and maximize surgical efficiency without compromising safety. Grafting is regularly performed to reduce the risk of recurrence and stimulate osseous consolidation of the lytic lesion. As the incidence is low and treatment strategies are heterogeneous, there is no clear consensus for the treatment of simple cysts or intraosseous lipomas of the calcaneus. The objectives of this study are (a) to present medium to long-term results after endoscopic resection and grafting with allogenic cancellous bone or bioresorbable hydroxyapatite and calcium sulfate cement, and (b) to add further evidence to the discussion of whether calcaneal SBC and IOL are the same entity at different developmental stages. Between 2012 and 2019, a total of 25 benign bone tumors consisting of 17 SBCs and 8 IOLs were treated by A.T. with endoscopic resection and grafting, comprising the largest cohort to date. For grafting, 12 patients received allogenic cancellous bone (group A) and 13 patients received injectable bone substitute (group B). Pre- and postoperative imaging using plain X-rays and MRI was retrospectively analyzed with a mean follow-up time of 24.5 months to assess tumor size, osseous consolidation (modified Neer classification), and tumor recurrence. A retrospective chart analysis focusing on adverse intra- and perioperative events and other complications associated with the surgical procedure was performed using the modified Clavien–Dindo classification (CD1-3). A total of 12/13 cases with allogenic bone grafting showed a Neer Type 1 osseous healing of the tumorous lesion after endoscopic resection, whereas only 5/11 cases with injectable bone substitute showed sufficient healing (types 1 and 2). There were three recurrent cysts (Neer 4) and two persistent cysts (Neer 3) after using injectable bone substitute. Two CD1 complications were observed in group A (prolonged wound drainage, sural neuritis) and eight complications were observed in group B (6× CD1, 2× CD3). At least two IOLs diagnosed preoperatively using MRI were ultimately identified as SBCs upon histopathologic examination. Allogenic cancellous bone grafting after endoscopic resection of calcaneal SBC or IOL showed a very low rate of complications and no tumor recurrence in our series. On the other hand, depending on the material used, injectable bone substitute showed a high rate of “white-out” (excessive drainage), resulting in multiple complications such as prolonged wound healing, insufficient permanent defect filling, recurrence, and revision surgery. Over time, calcaneal SBC may transform into IOL, exhibiting distinct features of both entities simultaneously during ossoscopy and histopathological analysis. Full article
(This article belongs to the Special Issue Updates in the Orthopedic Management of Foot Disorders)
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21 pages, 4885 KiB  
Article
Effect of Platelet-Rich Plasma Addition on the Chemical Properties and Biological Activity of Calcium Sulfate Hemihydrate Bone Cement
by Jingyu Liu, Yifan Wang, Yanqin Liang, Shengli Zhu, Hui Jiang, Shuilin Wu, Xiang Ge and Zhaoyang Li
Biomimetics 2023, 8(2), 262; https://doi.org/10.3390/biomimetics8020262 - 15 Jun 2023
Cited by 4 | Viewed by 2339
Abstract
Currently, platelet-rich plasma (PRP) is an attractive additive for bone repair materials. PRP could enhance the osteoconductive and osteoinductive of bone cement, as well as modulate the degradation rate of calcium sulfate hemihydrate (CSH). The focus of this study was to investigate the [...] Read more.
Currently, platelet-rich plasma (PRP) is an attractive additive for bone repair materials. PRP could enhance the osteoconductive and osteoinductive of bone cement, as well as modulate the degradation rate of calcium sulfate hemihydrate (CSH). The focus of this study was to investigate the effect of different PRP ratios (P1: 20 vol%, P2: 40 vol%, and P3: 60 vol%) on the chemical properties and biological activity of bone cement. The injectability and compressive strength of the experimental group were significantly higher than those of the control. On the other hand, the addition of PRP decreased the crystal size of CSH and prolonged the degradation time. More importantly, the cell proliferation of L929 and MC3T3-E1 cells was promoted. Furthermore, qRT-PCR, alizarin red staining, and western blot analyses showed that the expressions of osteocalcin (OCN) and Runt-related transcription factor 2 (Runx2) genes and β-catenin protein were up-regulated, and mineralization of extracellular matrix was enhanced. Overall, this study provided insight into how to improve the biological activity of bone cement through PRP incorporation. Full article
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16 pages, 7565 KiB  
Article
Effects of ATP on the Physicochemical Properties and Cytocompatibility of Calcium Sulfate/Calcium Citrate Composite Cement
by Xiangyue Liu, Hong Chen, Haohao Ren, Bo Wang, Xiaodan Li, Suping Peng, Qiyi Zhang and Yonggang Yan
Materials 2023, 16(11), 3947; https://doi.org/10.3390/ma16113947 - 25 May 2023
Cited by 3 | Viewed by 2051
Abstract
Adenosine triphosphate (ATP), acting as a source of energy, has effects on cellular activities, such as adhesion, proliferation, and differentiation. In this study, ATP-loaded calcium sulfate hemihydrate/calcium citrate tetrahydrate cement (ATP/CSH/CCT) was successfully prepared for the first time. The effect of different contents [...] Read more.
Adenosine triphosphate (ATP), acting as a source of energy, has effects on cellular activities, such as adhesion, proliferation, and differentiation. In this study, ATP-loaded calcium sulfate hemihydrate/calcium citrate tetrahydrate cement (ATP/CSH/CCT) was successfully prepared for the first time. The effect of different contents of ATP on the structure and physicochemical properties of ATP/CSH/CCT was also studied in detail. The results indicated that incorporating ATP into the cement did not significantly alter their structures. However, the addition ratio of ATP directly impacted the mechanical properties and in vitro degradation properties of the composite bone cement. The compressive strength of ATP/CSH/CCT gradually decreased with an increasing ATP content. The degradation rate of ATP/CSH/CCT did not significantly change at low concentrations of ATP, but it increased with a higher ATP content. The composite cement induced the deposition of a Ca-P layer in a phosphate buffer solution (PBS, pH = 7.4). Additionally, the release of ATP from the composite cement was controlled. The ATP was controlled releasing at the 0.5% and 1% ATP in cement by the diffusion of ATP and the degradation of the cement, whereas it was controlled by the diffusion process merely at the 0.1% ATP in cement. Furthermore, ATP/CSH/CCT demonstrated good cytoactivity with the addition of ATP and is expected to be used for the repair and regeneration of bone tissue. Full article
(This article belongs to the Special Issue The 15th Anniversary of Materials—Recent Advances in Biomaterials)
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26 pages, 2536 KiB  
Review
Prosthetic Joint Infections: Biofilm Formation, Management, and the Potential of Mesoporous Bioactive Glass as a New Treatment Option
by Dana Almasri and Yaser Dahman
Pharmaceutics 2023, 15(5), 1401; https://doi.org/10.3390/pharmaceutics15051401 - 3 May 2023
Cited by 13 | Viewed by 5442
Abstract
Infection of prosthetic joints is one of the biggest challenges to a successful replacement of the joint after a total joint arthroplasty. Such infections are caused by bacterial colonies that are difficult to treat by systemic delivery of antibiotics. Local delivery of antibiotics [...] Read more.
Infection of prosthetic joints is one of the biggest challenges to a successful replacement of the joint after a total joint arthroplasty. Such infections are caused by bacterial colonies that are difficult to treat by systemic delivery of antibiotics. Local delivery of antibiotics can prove to be the solution to such a devastating outcome that impacts patients’ health and ability to regain function in their joints as well as costs the healthcare system millions of dollars every year. This review will discuss prosthetic joint infections in detail with a focus on the development, management, and diagnosis of the infections. Surgeons often opt to use polymethacrylate cement locally to deliver antibiotics; however, due to the rapid release of antibiotics, non-biodegradability, and high chance of reinfection, the search for alternatives is in high demand. One of the most researched alternatives to current treatments is the use of biodegradable and highly compatible bioactive glass. The novelty of this review lies in its focus on mesoporous bioactive glass as a potential alternative to current treatments for prosthetic joint infection. Mesoporous bioactive glass is the focus of this review because it has a higher capacity to deliver biomolecules, stimulate bone growth, and treat infections after prosthetic joint replacement surgeries. The review also examines different synthesis methods, compositions, and properties of mesoporous bioactive glass, highlighting its potential as a biomaterial for the treatment of joint infections. Full article
(This article belongs to the Special Issue Design of Mesoporous Materials for Biomedical Application)
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17 pages, 2263 KiB  
Review
Biodegradable Cements for Bone Regeneration
by Dachuan Liu, Chen Cui, Weicheng Chen, Jiaxu Shi, Bin Li and Song Chen
J. Funct. Biomater. 2023, 14(3), 134; https://doi.org/10.3390/jfb14030134 - 27 Feb 2023
Cited by 38 | Viewed by 6139
Abstract
Bone cements such as polymethyl methacrylate and calcium phosphates have been widely used for the reconstruction of bone. Despite their remarkable clinical success, the low degradation rate of these materials hampers a broader clinical use. Matching the degradation rate of the materials with [...] Read more.
Bone cements such as polymethyl methacrylate and calcium phosphates have been widely used for the reconstruction of bone. Despite their remarkable clinical success, the low degradation rate of these materials hampers a broader clinical use. Matching the degradation rate of the materials with neo bone formation remains a challenge for bone-repairing materials. Moreover, questions such as the mechanism of degradation and how the composition of the materials contribute to the degradation property remain unanswered. Therefore, the review provides an overview of currently used biodegradable bone cements such as calcium phosphates (CaP), calcium sulfates and organic-inorganic composites. The possible degradation mechanism and clinical performance of the biodegradable cements are summarized. This paper reviews up-to-date research and applications of biodegradable cements, hoping to provide researchers in the field with inspirations and references. Full article
(This article belongs to the Special Issue Active Biomedical Materials and Their Applications)
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17 pages, 8155 KiB  
Article
Injectability, Processability, Drug Loading, and Antibacterial Activity of Gentamicin-Impregnated Mesoporous Bioactive Glass Composite Calcium Phosphate Bone Cement In Vitro
by Ming-Hsien Hu, Pei-Yi Chu, Ssu-Meng Huang, Bo-Sin Shih, Chia-Ling Ko, Jin-Jia Hu and Wen-Cheng Chen
Biomimetics 2022, 7(3), 121; https://doi.org/10.3390/biomimetics7030121 - 28 Aug 2022
Cited by 17 | Viewed by 4855
Abstract
Calcium phosphate cement (CPC) is similar to bone in composition and has plasticity, while mesoporous bioactive glass (MBG) has the advantage of releasing Si, which can promote osteogenic properties and drug loading capacity. A sol–gel-prepared MBG micro-powder (mMBG) and further impregnated antibiotic gentamicin [...] Read more.
Calcium phosphate cement (CPC) is similar to bone in composition and has plasticity, while mesoporous bioactive glass (MBG) has the advantage of releasing Si, which can promote osteogenic properties and drug loading capacity. A sol–gel-prepared MBG micro-powder (mMBG) and further impregnated antibiotic gentamicin sulfate (Genta@mMBG: 2, 3, and 4 mg/mL) antibiotic were added to CPC at different weight ratios (5, 10, and 15 wt.%) to study CPC’s potential clinical applications. Different ratios of mMBG/CPC composite bone cement showed good injectability and disintegration resistance, but with increasing mMBG addition, the working/setting time and compressive strength decreased. The maximum additive amount was 10 wt.% mMBG due to the working time of ~5 min, the setting time of ~10 min, and the compressive strength of ~51 MPa, indicating that it was more suitable for clinical surgical applications than the other groups. The 2Genta@mMBG group loaded with 2 mg/mL gentamicin had good antibacterial activity, and the 10 wt.% 2Genta@mMBG/CPC composite bone cement still had good antibacterial activity but reduced the initial release of Genta. 2Genta@mMBG was found to have slight cytotoxicity, so 2Genta@mMBG was composited into CPC to improve the biocompatibility and to endow CPC with more advantages for clinical application. Full article
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12 pages, 3307 KiB  
Article
Biomechanical Comparison of Salvage Pedicle Screw Augmentations Using Different Biomaterials
by Yun-Da Li, Ming-Kai Hsieh, De-Mei Lee, Yi-Jiun Lin, Tsung-Ting Tsai, Po-Liang Lai and Ching-Lung Tai
Appl. Sci. 2022, 12(15), 7792; https://doi.org/10.3390/app12157792 - 3 Aug 2022
Cited by 2 | Viewed by 2463
Abstract
Allograft bone particles, hydroxyapatite/β-hydroxyapatite-tricalcium phosphate (HA/β-TCP), calcium sulfate (CS), and polymethylmethacrylate (PMMA) bone cement are biomaterials clinically used to fill defective pedicles for pedicle screw augmentation. Few studies have systematically investigated the effects of various biomaterials utilized for salvage screw stabilization. The aim [...] Read more.
Allograft bone particles, hydroxyapatite/β-hydroxyapatite-tricalcium phosphate (HA/β-TCP), calcium sulfate (CS), and polymethylmethacrylate (PMMA) bone cement are biomaterials clinically used to fill defective pedicles for pedicle screw augmentation. Few studies have systematically investigated the effects of various biomaterials utilized for salvage screw stabilization. The aim of this study was to evaluate the biomechanical properties of screws augmented with these four different materials and the effect of different pilot hole sizes and bone densities on screw fixation strength. Commercially available synthetic bones with three different densities (7.5 pcf, 15pcf, 30 pcf) simulating different degrees of bone density were utilized as substitutes for human bone. Two different pilot hole sizes (3.2 mm and 7.0 mm in diameter) were prepared on test blocks to simulate primary and revision pedicle screw fixation, respectively. Following separate specimen preparation with these four different filling biomaterials, a screw pullout test was conducted using a material test machine, and the average maximal screw pullout strength was compared among groups. The average maximal pullout strength of the materials, presented in descending order, was as follows: bone cement, calcium sulfate, HA/β-TCP, allograft bone chips and the control. In samples in both the 3.2 mm pilot-hole and 7.0 mm pilot-hole groups, the average maximal pullout strength of these four materials increased with increasing bone density. The average maximal pullout strength of the bone cement augmented salvage screw (7.0 mm) was apparently elevated in the 7.5 pcf test block. Salvage pedicle screw augmentation with allograft bone chips, HA/β-TCP, calcium sulfate, and bone cement are all feasible methods and can offer better pullout strength than materials in the non-augmentation group. Bone cement provides the most significantly augmented effect in each pilot hole size and bone density setting and could be considered preferentially to achieve larger initial stability during revision surgery, especially for bones with osteoporotic quality. Full article
(This article belongs to the Section Biomedical Engineering)
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19 pages, 1678 KiB  
Review
Synthetic Material for Bone, Periodontal, and Dental Tissue Regeneration: Where Are We Now, and Where Are We Heading Next?
by Chia Wei Cheah, Nisreen Mohammed Al-Namnam, May Nak Lau, Ghee Seong Lim, Renukanth Raman, Peter Fairbairn and Wei Cheong Ngeow
Materials 2021, 14(20), 6123; https://doi.org/10.3390/ma14206123 - 15 Oct 2021
Cited by 75 | Viewed by 7366
Abstract
Alloplasts are synthetic, inorganic, biocompatible bone substitutes that function as defect fillers to repair skeletal defects. The acceptance of these substitutes by host tissues is determined by the pore diameter and the porosity and inter-connectivity. This narrative review appraises recent developments, characterization, and [...] Read more.
Alloplasts are synthetic, inorganic, biocompatible bone substitutes that function as defect fillers to repair skeletal defects. The acceptance of these substitutes by host tissues is determined by the pore diameter and the porosity and inter-connectivity. This narrative review appraises recent developments, characterization, and biological performance of different synthetic materials for bone, periodontal, and dental tissue regeneration. They include calcium phosphate cements and their variants β-tricalcium phosphate (β-TCP) ceramics and biphasic calcium phosphates (hydroxyapatite (HA) and β-TCP ceramics), calcium sulfate, bioactive glasses and polymer-based bone substitutes which include variants of polycaprolactone. In summary, the search for synthetic bone substitutes remains elusive with calcium compounds providing the best synthetic substitute. The combination of calcium sulphate and β-TCP provides improved handling of the materials, dispensing with the need for a traditional membrane in guided bone regeneration. Evidence is supportive of improved angiogenesis at the recipient sites. One such product, (EthOss® Regeneration, Silesden, UK) has won numerous awards internationally as a commercial success. Bioglasses and polymers, which have been used as medical devices, are still in the experimental stage for dental application. Polycaprolactone-TCP, one of the products in this category is currently undergoing further randomized clinical trials as a 3D socket preservation filler. These aforementioned products may have vast potential for substituting human/animal-based bone grafts. Full article
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17 pages, 22413 KiB  
Article
Tetracalcium Phosphate/Monetite/Calcium Sulfate Hemihdrate Biocement Powder Mixtures Prepared by the One-Step Synthesis for Preparation of Nanocrystalline Hydroxyapatite Biocement-Properties and In Vitro Evaluation
by Lubomir Medvecky, Maria Giretova, Radoslava Stulajterova, Lenka Luptakova and Tibor Sopcak
Materials 2021, 14(9), 2137; https://doi.org/10.3390/ma14092137 - 22 Apr 2021
Cited by 12 | Viewed by 3282
Abstract
A modified one-step process was used to prepare tetracalcium phosphate/monetite/calcium sulfate hemihydrate powder cement mixtures (CAS). The procedure allowed the formation of monetite and calcium sulfate hemihydrate (CSH) in the form of nanoparticles. It was hypothesized that the presence of nanoCSH in small [...] Read more.
A modified one-step process was used to prepare tetracalcium phosphate/monetite/calcium sulfate hemihydrate powder cement mixtures (CAS). The procedure allowed the formation of monetite and calcium sulfate hemihydrate (CSH) in the form of nanoparticles. It was hypothesized that the presence of nanoCSH in small amounts enhances the in vitro bioactivity of CAS cement in relation to osteogenic gene markers in mesenchymal stem cells (MSCs). The CAS powder mixtures with 15 and 5 wt.% CSH were prepared by milling powder tetracalcium phosphate in an ethanolic solution of both orthophosphoric and sulfuric acids. The CAS cements had short setting times (around 5 min). The fast setting of the cement samples after the addition of the liquid component (water solution of NaH2PO4) was due to the partial formation of calcium sulfate dihydrate and hydroxyapatite before soaking in SBF with a small change in the original phase composition in cement powder samples after milling. Nanocrystalline hydroxyapatite biocement was produced by soaking of cement samples after setting in simulated body fluid (SBF). The fast release of calcium ions from CAS5 cement, as well as a small rise in the pH of SBF during soaking, were demonstrated. After soaking in SBF for 7 days, the final product of the cement transformation was nanocrystalline hydroxyapatite. The compressive strength of the cement samples (up to 30 MPa) after soaking in simulated body fluid (SBF) was comparable to that of bone. Real time polymerase chain reaction (RT-PCR) analysis revealed statistically significant higher gene expressions of alkaline phosphatase (ALP), osteonectin (ON) and osteopontin (OP) in cells cultured for 14 days in CAS5 extract compared to CSH-free cement. The addition of a small amount of nanoCSH (5 wt.%) to the tetracalcium phosphate (TTCP)/monetite cement mixture significantly promoted the over expression of osteogenic markers in MSCs. The prepared CAS powder mixture with its enhanced bioactivity can be used for bone defect treatment and has good potential for bone healing. Full article
(This article belongs to the Special Issue Bioceramics and Bioactive Glass-Based Composites)
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13 pages, 6436 KiB  
Article
Elution Kinetics from Antibiotic-Loaded Calcium Sulfate Beads, Antibiotic-Loaded Polymethacrylate Spacers, and a Powdered Antibiotic Bolus for Surgical Site Infections in a Novel In Vitro Draining Knee Model
by Kelly Moore, Rebecca Wilson-van Os, Devendra H. Dusane, Jacob R. Brooks, Craig Delury, Sean S. Aiken, Phillip A. Laycock, Anne C. Sullivan, Jeffrey F. Granger, Matthew V. Dipane, Edward J. McPherson and Paul Stoodley
Antibiotics 2021, 10(3), 270; https://doi.org/10.3390/antibiotics10030270 - 8 Mar 2021
Cited by 14 | Viewed by 4473
Abstract
Antibiotic-tolerant bacterial biofilms are notorious in causing PJI. Antibiotic loaded calcium sulfate bead (CSB) bone void fillers and PMMA cement and powdered vancomycin (VP) have been used to achieve high local antibiotic concentrations; however, the effect of drainage on concentration is poorly understood. [...] Read more.
Antibiotic-tolerant bacterial biofilms are notorious in causing PJI. Antibiotic loaded calcium sulfate bead (CSB) bone void fillers and PMMA cement and powdered vancomycin (VP) have been used to achieve high local antibiotic concentrations; however, the effect of drainage on concentration is poorly understood. We designed an in vitro flow reactor which provides post-surgical drainage rates after knee revision surgery to determine antibiotic concentration profiles. Tobramycin and vancomycin concentrations were determined using LCMS, zones of inhibition confirmed potency and the area under the concentration–time curve (AUC) at various time points was used to compare applications. Concentrations of antibiotcs from the PMMA and CSB initially increased then decreased before increasing after 2 to 3 h, correlating with decreased drainage, demonstrating that concentration was controlled by both release and flow rates. VP achieved the greatest AUC after 2 h, but rapidly dropped below inhibitory levels. CSB combined with PMMA achieved the greatest AUC after 2 h. The combination of PMMA and CSB may present an effective combination for killing biofilm bacteria; however, cytotoxicity and appropriate antibiotic stewardship should be considered. The model may be useful in comparing antibiotic concentration profiles when varying fluid exchange is important. However, further studies are required to assess its utility for predicting clinical efficacy. Full article
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16 pages, 2018 KiB  
Review
Synthetic Bone Substitutes and Mechanical Devices for the Augmentation of Osteoporotic Proximal Humeral Fractures: A Systematic Review of Clinical Studies
by Giuseppe Marongiu, Marco Verona, Gaia Cardoni and Antonio Capone
J. Funct. Biomater. 2020, 11(2), 29; https://doi.org/10.3390/jfb11020029 - 5 May 2020
Cited by 24 | Viewed by 5915
Abstract
Background: Different augmentation techniques have been described in the literature in addition to the surgical treatment of proximal humeral fractures. The aim of this systematic review was to analyze the use of cements, bone substitutes, and other devices for the augmentation of proximal [...] Read more.
Background: Different augmentation techniques have been described in the literature in addition to the surgical treatment of proximal humeral fractures. The aim of this systematic review was to analyze the use of cements, bone substitutes, and other devices for the augmentation of proximal humeral fractures. Methods: A systematic review was conducted by using PubMed/MEDLINE, ISI Web of Knowledge, Cochrane Library, Scopus/EMBASE, and Google Scholar databases according the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines over the years 1966 to 2019. The search term “humeral fracture proximal” was combined with “augmentation”; “polymethylmethacrylate, PMMA”; “cement”; “bone substitutes”; “hydroxyapatite”; “calcium phosphates”; “calcium sulfate”; “cell therapies”, and “tissue engineering” to find the literature relevant to the topic under review. Results: A total of 10 clinical studies considered eligible for the review, with a total of 308 patients, were included. Mean age at the time of injury was 68.8 years (range of 58–92). The most commonly described techniques were reinforcing the screw–bone interface with bone PMMA cement (three studies), filling the metaphyseal void with synthetic bone substitutes (five studies), and enhancing structural support with metallic devices (two studies). Conclusion: PMMA cementation could improve screw-tip fixation. Calcium phosphate and calcium sulfate injectable composites provided good biocompatibility, osteoconductivity, and lower mechanical failure rate when compared to non-augmented fractures. Mechanical devices currently have a limited role. However, the available evidence is provided mainly by level III to IV studies, and none of the proposed techniques have been sufficiently studied. Full article
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