PROSPECTS OF USING TITANIUM IMPLANTS WITH PREDETERMINED OSTEOGENIC PROPERTIES

Abstract

The paper discusses the benefits and drawbacks of using titanium implants in spine surgery. Improved fixation of titanium implants in bone tissue is achieved by applying a variety of textured and nano-based coatings on their surfaces. Coatings made of osteotropic hydroxyapatite (HA)- and tricalciumphosphate (TCP)-based materials prevail over allogenic materials in many features. This permits to achieve positive results in bone defect osteoplasty. However, HA and TCP do not completely meet the needs of clinicians due to the lack of apparent osteoinductive properties. The guided bone regeneration requires creation of initial conditions for the ordered proliferation of osteogenic cells and capillaries in a predetermined space. A prerequisite for this is the presence of biologically active substances providing osteoinduction of osteoplastic material to form a matrix on which the bone tissue will develop. Candidate substances are various fractions of bone morphogenetic protein (BMP) which induce bone regeneration. The advantages of various physicochemical treatments of titanium implants (plasma, ion, sandblasting, ablative, etc.) are still debated, but their clinical use requires further research.