Alpha-tricalcium Phosphate Research Articles

Improvement of calcium phosphate scaffold osteogenesis in vitro via combination of glutamate-modified BMP-2 peptides

Alpha-tricalcium phosphate (α-TCP) based porous scaffolds have superior osteoconduction and osteoinduction in bone tissue engineering, furthermore, these 3D porous scaffolds can be used as efficient drug delivery carriers. In the concept of tissue engineering, the “drugs” could be defined as drug molecules or biomacromolecules, even cells. These “drugs” have endowed the scaffolds which were laden improved abilities compared with the blank scaffolds. In this study, we anchored osteogenic bone morphogenetic protein-2 (BMP-2) derived peptides to α-TCP 3D porous scaffolds by linking the E7 domain to the target peptides, constructed the modified active peptides (E7BMP-2 peptides) delivery system, which finally achieved the modified peptides sustaining release and enhanced rat bone marrow mesenchymal stem cells (BMSCs) osteogenic differentiation in vitro. The α-TCP 3D porous scaffolds had micropores and interconnected micropores which expanded surface area of the scaffolds. The release test testified the constructed the delivery system had realized long-term release in which the peptides dosage could be detected by the BCA protein assay kit after 10 days compared with BMP-2 proteins which absorbed on the same α-TCP 3D porous scaffolds. The constructed E7BMP-2 peptides delivery system supported rat BMSCs osteogenic differentiation in the form of improving the genes expression levels of Runx2, ALP and OCN. Based on electrostatic interactions, E7 domain fastened combination between the active BMP-2 derived peptides and the α-TCP 3D porous scaffolds, the sustaining E7BMP-2 peptides release promoted the BMSCs osteogenesis as BMP-2 proteins did, which endowed α-TCP 3D porous scaffolds enhanced osteoinductive abilities in vitro.

Treatment of the benign lytic lesions of the proximal femur with synthetic bone graft

BackgroundBenign bone tumors and tumor-like conditions are commonly located in the proximal femur. The main indications for surgical treatment are lesions with impending or actual pathological fractures, or with aggressive or recurrent lesions. However, patients complaining of persistent pain, limping, or abnormal gait patterns are also considered for surgical treatment. In this study, we describe the outcomes of the surgical treatment of benign lytic lesions of the proximal femur by curettage followed by implantation of synthetic bone graft.MethodsThis retrospective study included 27 patients (22 females and 5 males) with benign lytic lesions of the proximal femur. The average age was 25.5 years (6–65 years), and the mean follow-up period was 54.5 months (9–145 months). The histopathological diagnoses were fibrous dysplasia (8 patients), simple bone cyst (8 patients), chondroblastoma (7 patients), giant cell tumor (3 patients), and eosinophilic granuloma (1 patient). These lesions were managed with curettage followed by implantation of the bone defects with alpha tricalcium phosphate in 14 patients, beta tricalcium phosphate granules in 11 patients, hydroxyapatite granules in 1 patient, and combined beta tricalcium phosphate and hydroxyapatite granules in 1 patient. Internal fixation was performed in three patients.ResultsThe mean operative time was 143 min (80–245 min). Patients had regained normal unrestricted activity without pain at the operation site. Patients treated with beta tricalcium phosphate achieved radiographic consolidation of the bone defects within 1 year after the surgery, and those treated with alpha tricalcium phosphate or hydroxyapatite experienced no progression nor recurrence of the lesions. Local tumor recurrence was observed in one patient with giant cell tumor 5 years after the surgery. Post-operative pathological fracture was occurred in one patient with a simple bone cyst of the subtrochanteric region 1 month after surgery. No post-operative infection was observed.ConclusionWe concluded that the treatment of benign lytic lesions of the proximal femur, either primary or recurrent, using synthetic bone graft is a safe and satisfactory method and the addition of internal fixation should be carefully planned.

Effect of Composition and Temperature to the HA/ß-TCP Composite

The aim of this study is to fabricate hydroxyapatite (HA) and beta-tricalcium phosphate (β-TCP) composite by varying the HA/β-TCP compositions (100% HA, 80% HA with 20% β-TCP, 60% HA with 40% β-TCP, and 50% HA with 50% β-TCP) and sintering temperatures (1000°C and 1200°C). The powders are mixed with ethanol by using agate mortar, dried in oven (80°C, 24 hours) and uniaxially pressed into 16 mm diameter pellets followed by sintering. Samples are characterized by bulk density testing, phase analysis using X-ray Diffraction (XRD) and Vickers hardness test. Pure HA powder sintered at 1200°C shows the highest density and hardness with 3.090 gcm−3 and 421.70 HV respectively. XRD phase analysis show decrease of HA phase at higher sintering temperature due to phase decomposition of HA into β-TCP and alpha-tricalcium phosphate (α-TCP). Both HA/β-TCP composition and sintering temperature are significant factors to the hardness with sintering temperature the more dominant factor.

Surface modification of porous alpha-tricalcium phosphate granules with heparin enhanced their early osteogenic capability in a rat calvarial defect model.

Heparin binds to and modulates various growth factors, potentially augmenting the bone-forming capability of biomaterials. Here, α-tricalcium phosphate (α-TCP) granules were modified with peptide containing the marine mussel-derived adhesive sequence, which reacts with α-TCP surface, and cationic sequence, which binds to heparin (α-Ph). α-Ph retained the α-TCP phase and intergranule spaces after the surface modification. The existence of heparin on α-Ph granules was confirmed using X-ray photoelectron spectroscopy. Granules of α-TCP and α-Ph were implanted into critical-size defects in rat calvaria for 4 weeks. Micro-computed tomography, histological evaluation, and Alcian blue staining revealed that α-Ph induced superior bone formation compared with α-TCP. Newly formed bone on α-Ph was preferentially in contact with the Alcian blue-stained surfaces of granules. These results suggested that heparinization enhanced the early osteogenic capacity of α-TCP, possibly by modulating the secretion of Alcian blue-stained extracellular matrixes.

Fabrication and evaluation of interconnected porous carbonate apatite from alpha tricalcium phosphate spheres.

Carbonate apatite (CO3 Ap) blocks have attracted considerable attention as an artificial bone substitute material because CO3 Ap is a component of and shares properties with bone, including high osteoconductivity and replacement by bone similar to autografts. In this study, we fabricated an interconnected porous CO3 Ap block using α-tricalcium phosphate (TCP) spheres and evaluated the tissue response to this material in a rabbit tibial bone defect model. Interconnected porous α-TCP, the precursor of interconnected porous CO3 Ap, could not be fabricated directly by sintering α-TCP spheres. It was therefore made via a setting reaction with α-TCP spheres, yielding interconnected porous calcium-deficient hydroxyapatite that was subjected to heat treatment. Immersing the interconnected porous α-TCP in Na-CO3 -PO4 solution produced CO3 Ap, which retained the interconnected porous structure after the dissolution-precipitation reaction. The diametral tensile strength and porosity of the porous CO3 Ap were 1.8 ± 0.4 MPa and 55% ± 3.2%, respectively. Both porous and dense (control) CO3 Ap showed excellent tissue response and good osteoconductivity. At 4 weeks after surgery, approximately 15% ± 4.9% of the tibial bone defect was filled with new bone when reconstruction was performed using porous CO3 Ap; this amount was five times greater than that obtained with dense CO3 Ap. At 12 weeks after surgery, for porous CO3 Ap, approximately 47% of the defect was filled with new bone as compared to 16% for dense CO3 Ap. Thus, the interconnected porous CO3 Ap block is a promising artificial bone substitute material for the treatment of bone defects caused by large fractures or bone tumor resection. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 107B: 269-277, 2019.

Strength and fracture mechanism of iron reinforced tricalcium phosphate cermet fabricated by spark plasma sintering.

The present work studies the microstructure and mechanical performance of tricalcium phosphate (TCP) based cermet toughened by iron particles. A novelty arises by the employment of spark plasma sintering for fabrication of the cermet. Results showed partial transformation of initial alpha TCP matrix to beta phase and the absence of oxidation of iron particles, as well as a lack of chemical reaction between TCP and iron components during sintering. The values of compressive and tensile strength of TCP/Fe cermet were 3.2 and 2.5 times, respectively, greater than those of monolithic TCP. Fracture analysis revealed the simultaneous action of crack-bridging and crack-deflection microstructural toughening mechanisms under compression. In contrast, under tension the reinforcing mechanism was only crack-bridging, being the reason for smaller increment of strength. Elastic properties of the cermet better matched values reported for human cortical bone. Thereby the new TCP/Fe cermet has potential for eventual use as a material for bone fractures fixation under load-bearing conditions.

High strength, biodegradable and cytocompatible alpha tricalcium phosphate-iron composites for temporal reduction of bone fractures

In this work alpha tricalcium phosphate (α-TCP)/iron (Fe) composites were developed as a new family of biodegradable, load-bearing and cytocompatible materials. The composites with composition from pure ceramic to pure metallic samples were consolidated by pulsed electric current assisted sintering to minimise processing time and temperature while improving their mechanical performance. The mechanical strength of the composites was increased and controlled with the Fe content, passing from brittle to ductile failure. In particular, the addition of 25 vol% of Fe produced a ceramic matrix composite with elastic modulus much closer to cortical bone than that of titanium or biodegradable magnesium alloys and specific compressive strength above that of stainless steel, chromium-cobalt alloys and pure titanium, currently used in clinic for internal fracture fixation. All the composites studied exhibited higher degradation rate than their individual components, presenting values around 200 μm/year, but also their compressive strength did not show a significant reduction in the period required for bone fracture consolidation. Composites showed preferential degradation of α-TCP areas rather than β-TCP areas, suggesting that α-TCP can produce composites with higher degradation rate. The composites were cytocompatible both in indirect and direct contact with bone cells. Osteoblast-like cells attached and spread on the surface of the composites, presenting proliferation rate similar to cells on tissue culture-grade polystyrene and they showed alkaline phosphatase activity. Therefore, this new family of composites is a potential alternative to produce implants for temporal reduction of bone fractures. Statement of SignificanceBiodegradable alpha-tricalcium phosphate/iron (α-TCP/Fe) composites are promising candidates for the fabrication of temporal osteosynthesis devices. Similar to biodegradable metals, these composites can avoid implant removal after bone fracture healing, particularly in young patients. In this work, α-TCP/Fe composites are studied for the first time in a wide range of compositions, showing not only higher degradation rate in vitro than pure components, but also good cytocompatibility and mechanical properties controllable with the Fe content. Ceramic matrix composites show high specific strength and low elastic modulus, thus better fulfilling the requirements for bone fractures fixation. A significant advance over previous works on the topic is the use of pulsed electric current assisted sintering together with α-TCP, convenient to improve the mechanical performance and degradation rate, respectively.

Influence of the Ca/P ratio and cooling rate on the allotropic α↔β-tricalcium phosphate phase transformations

Alpha-tricalcium phosphate (α-TCP) is a component of particular interest in the formulation of apatitic calcium phosphate based bone cements. During the setting reaction of this type of cements, a calcium deficient hydroxyapatite with composition similar to bone hydroxyapatite is formed. But the purity levels of the commercially available products based on α-TCP are generally low, and their prices are prohibitive. Such stringent conditions are pushing most of the researchers in the area of bone cements towards preparing α-TCP in their own laboratories. The low degree of purity of α-TCP based products is generally due to an incomplete β-TCP → α-TCP phase transformation and/or to a partial α-TCP → β-TCP reversal during cooling. Despite extensive research efforts, contradictory reports exist about the effects of composition of the starting material, cooling rates and the importance of quenching for maintaining α-TCP purity. The present work aims at shedding further light on this issue by controlling the relevant parameters of wet synthesis of the starting β-TCP powders and their heat treatment schedule in order to transform them in high purity α-TCP products. The key experimental variables investigated included the composition of the starting β-TCP powders, namely the Ca/P ratio, the maximum heat treatment temperatures, and the cooling rates.

Design and properties of a novel radiopaque injectable apatitic calcium phosphate cement, suitable for image-guided implantation.

An injectable purely apatitic calcium phosphate cement (CPC) was successfully combined to a water-soluble radiopaque agent (i.e., Xenetix® ), to result in an optimized composition that was found to be as satisfactory as poly(methyl methacrylate) (PMMA) formulations used for vertebroplasty, in terms of radiopacity, texture and injectability. For that purpose, the Xenetix dosage in the cement paste was optimized by injection of the radiopaque CPC in human cadaveric vertebrae under classical PMMA vertebroplasty conditions, performed by interventional radiologists familiar with this surgical procedure. When present in the cement paste up to 70 mg I mL-1 , Xenetix did not influence the injectability, cohesion, and setting time of the resulting composite. After hardening of the material, the same observation was made regarding the microstructure, mechanical strength and alpha-tricalcium phosphate to calcium deficient apatite transformation rate. Upon implantation in bone in a small animal model (rat), the biocompatibility of the Xenetix-containing CPC was evidenced. Moreover, an almost quantitative release of the contrast agent was found to occur rapidly, on the basis of in vitro static and dynamic quantitative studies simulating in vivo implantation. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2786-2795, 2018.

Novel self-gelling injectable hydrogel/alpha-tricalcium phosphate composites for bone regeneration: Physiochemical and microcomputer tomographical characterization.

Mineralized hydrogels are increasingly gaining attention as biomaterials for bone regeneration. The most common mineralization strategy has been addition of preformed inorganic particles during hydrogel formation. This maintains injectability. One common form of bone cement is formed by mixing particles of the highly reactive calcium phosphate alpha-tricalcium phosphate (α-TCP) with water to form hydroxyapatite (HA). The calcium ions released during this reaction can be exploited to crosslink anionic, calcium-binding polymers such as the polysaccharide gellan gum (GG) to induce hydrogel formation. In this study, three different amounts of α-TCP particles were added to GG polymer solution to generate novel, injectable hydrogel-inorganic composites. Distribution of the inorganic phase in the hydrogel was studied by high resolution microcomputer tomography (µCT). Gelation occurred within 30 min. α-TCP converted to HA. µCT revealed inhomogeneous distribution of the inorganic phase in the composites. These results demonstrate the potential of the composites as alternatives to traditional α-TCP bone cement and pave the way for incorporation of biologically active substances and in vitro and in vivo testing. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 822-828, 2018.

Periodontal regeneration induced by porous alpha-tricalcium phosphate with immobilized basic fibroblast growth factor in a canine model of 2-wall periodontal defects.

We evaluated the effect of porous alpha-tricalcium phosphate (α-TCP) with immobilized basic fibroblast growth factor (bFGF) on periodontal regeneration in a canine model of 2-wall periodontal defects. Identical bone defects were made in the canine mandible; six defects in each animal were filled with porous α-TCP with bFGF bound via heparin (bFGF group), and the remaining defects were filled with unmodified porous α-TCP (control group). Micro-computed tomography and histological evaluation were performed at 2, 4, and 8weeks post-implantation. The bone mineral content of the bFGF group was higher than that of the control group at 2 and 4weeks (p<0.05). Histological evaluation at 2weeks post-implantation revealed degradation of the porous α-TCP, and bone had formed on the surface of α-TCP particles in the bFGF group. Some of these collagen fibers connected the newly formed cementum with the alveolar bone, revealing the formation of new periodontal ligaments with Sharpey's fibers. At 8weeks, continuous cortical bone with a Haversian structure covered the top of the bone defects in the bFGF group. These findings indicate that porous α-TCP with immobilized bFGF could promote periodontal regeneration at the early regeneration phase in a canine model of 2-wall periodontal defects.

Nano‑calcium phosphate bone cement based on Si-stabilized α-tricalcium phosphate with improved mechanical properties

This study aimed to develop nano‑calcium phosphate cement (nCPC) and evaluate the effect of nanosized precursors on mechanical, physical and handling properties (injectability and setting time) as well as conversion rate of nano-reactants into nano-hydroxyapatite (nHA). In this study, while alpha tricalcium phosphate (α-TCP, 98wt%) and HA (2wt%) were applied as the powder phase, 2.5wt% NaH2PO4 solution was used as liquid phase of cement. Before nano-CPC preparation, Si-stabilized α-TCP nanopowder with particle size of 10±3.6nm was firstly synthesized in a two-step process of sol-gel followed by mechanical alloying. Moreover, HA nanopowder with particle size of 32±3.6nm was synthesized using sol-gel process. Our results revealed that after 3days of immersion in ringer's solution, reactants almost completely converted to nHA. Moreover, the initial and final setting time of nano-CPC was obtained 6.3±2.1min and 14.3±4.0min, respectively. Furthermore, injectability of this formulation was reached 87.90±2.60%. In addition, our results confirmed that the compressive strength and modulus of nano-CPC enhanced with increasing immersion time in ringer's solution from 9.50±1.27MPa and 0.38±0.07GPa (at 1day) to 18.70±2.23MPa and 0.57±0.15GPa (at 5days), respectively. Finally, in order to evaluate cellular responses to nano-CPC, MG63 cells were cultured on it and cell morphology and cytotoxicity were evaluated. Results revealed that nano-CPC enhanced proliferation and spreading of osteoblast like cells compared to control (tissue culture plate) which could be due to both appropriate physical and chemical properties of nano-CPC which stimulate cell proliferation. Our findings suggest the formation of an injectable nano-CPC with appropriate mechanical, physical and degradation rate which can potentially utilized for filling bone defects.

インプラント埋入時における歯槽骨欠損部の新生骨再生過程に及ぼすα-TCPの影響(大阪歯科大学大学院歯学研究科博士(歯学)学位論文内容要旨および論文審査結果要旨の公表)

インプラント埋入時における歯槽骨欠損部の新生骨再生過程に及ぼすα-TCPの影響(大阪歯科大学大学院歯学研究科博士(歯学)学位論文内容要旨および論文審査結果要旨の公表)

コラーゲンモデルポリペプチドと異なるサイズのα-TCPの混合による骨再生能の評価(大阪歯科大学大学院歯学研究科博士(歯学)学位論文内容要旨および論文審査結果要旨の公表)

コラーゲンモデルポリペプチドと異なるサイズのα-TCPの混合による骨再生能の評価(大阪歯科大学大学院歯学研究科博士(歯学)学位論文内容要旨および論文審査結果要旨の公表)

Fabrication of interconnected porous calcium-deficient hydroxyapatite using the setting reaction of α tricalcium phosphate spherical granules

Abstract Interconnected porous calcium-deficient hydroxyapatite (cdHAp) blocks may be an ideal biomaterial to repair bone defects because of their greater similarity to human bone than that of sintered hydroxyapatite (HAp) with respect to calcium content and crystallinity. In particular, the interconnected pores in cdHAp may provide pathways for cell migration and tissue ingrowth. In this study, the feasibility of fabricating interconnected porous cdHAp blocks through the setting reaction of alpha-tricalcium phosphate (αTCP) spherical granules was investigated. It was found that regulation of cdHAp formation was important to fabricate interconnected porous cdHAp blocks. That is, cdHAp needed to precipitate preferentially at the contacting areas between αTCP spherical granules. Exposure of αTCP spherical granules to steam under appropriate pressure was effective for this purpose. When αTCP spherical granules were immersed in water at 100 °C, the setting reaction resulted in dense cdHAp blocks because of the free crystal growth of cdHAp in water. Therefore, steam was used to localize the water at the contacting areas between αTCP spherical granules, which was driven by the surface tension of the water. Without an applied load, no setting reaction was observed when αTCP spherical granules were exposed to steam at 100 °C for 12 h. In contrast, under a load of 20 MPa, cdHAp precipitated to bridge spherical granules, providing an interconnected porous cdHAp block. The porosity and diametral tensile strength of this block were approximately 63% and 1.5 MPa, respectively.

An unusual case of proximal humeral simple bone cyst in an adult from secondary cystic change

BackgroundSimple bone cysts (SBC) have been documented to occur in adults with closed physeal plates, most commonly affecting the calcaneus in this patient subset. Although most authors theorize an association to trauma, etiology of simple bone cysts remains an enigma up to now.Case presentationA 26-year-old kickboxing coach sought consult for a painful right shoulder which on radiographs and magnetic resonance (MR) imaging showed a proximal humeral lesion with signs of ossification. The patient was lost to follow-up but again sought consult after 3 years for the recurring complaint. On repeat radiographs, computed tomography (CT) scan, and MR images, tumor enlargement with cystic findings typical of simple bone cyst were documented. Diagnostic aspiration of the lesion was firstly done, revealing straw-colored fluid. The patient then underwent intralesional curettage with alpha-tricalcium phosphate cement reconstruction of the lytic defect. No perioperative complications were incurred, and on latest follow-up at 3 years postoperatively, Musculoskeletal Tumor Society (MSTS) and visual analog scale (VAS) pain scores were 30/30 and 0/10, respectively.ConclusionsThe authors believe their report provides support to a possible association to trauma of simple bone cysts occurring in the adult population with closed physes and suggest this subset of patients may require a different treatment approach from that for juvenile simple bone cysts.

Modification of calcium phosphate cement with poly (γ-glutamic acid) and its strontium salt for kyphoplasty application

To meet the requirements of minimally invasive surgical treatments for osteoporotic vertebral compression fracture, various strategies have been proposed to enhance the properties of calcium phosphate cement (CPC). Here, a new strategy was developed by incorporating poly (γ-glutamic acid) (γ-PGA) and its strontium salt into the formulation of alpha tricalcium phosphate (α-TCP)-based CPC. Effects of γ-PGA on the injectability, cohesion, setting times, mechanical compressive strengths and cytocompatibility were systematically studied. Results showed that the injectability, cohesion and setting times were considerably improved by introducing γ-PGA into the CPC. Moreover, after setting for 7days, the compressive strengths increased from 14.6±1.4MPa for pure CPC to 35.3±1.7MPa for CPC with 8.9wt% γ-PGA and further to 61.2±5.4MPa for CPC with 8.9wt% γ-PGA combined with its strontium salt. In vitro osteoblast proliferation tests showed that the group of CPC modified by γ-PGA and its strontium salt had better cytocompatibility than the pure CPC group. All results suggest that optimal properties were obtained for the cement with 8.9wt% γ-PGA added to its solid phases and using strontium salt as the reactive liquid phase, making it as a promising candidate for application in kyphoplasty.

Repair of bone defects using adipose-derived stem cells combined with alpha-tricalcium phosphate and gelatin sponge scaffolds in a rat model

Objectives This study aimed to evaluate the potential of adipose-derived stem cells (ASCs) combined with a modified α-tricalcium phosphate (α-TCP) or gelatin sponge (GS) scaffolds for bone healing in a rat model.Material and Methods Bone defects were surgically created in the femur of adult SHR rats and filled with the scaffolds, empty or combined with ASCs. The results were analyzed by histology and histomorphometry on days seven, 14, 30, and 60.Results Significantly increased bone repair was observed on days seven and 60 in animals treated with α-TCP/ASCs, and on day 14 in the group treated with GS/ASCs, when compared with the groups treated with the biomaterials alone. Intense fibroplasia was observed in the group treated with GS alone, on days 14 and 30.Conclusions Our results showed that the use of ASCs combined with α-TCP or GS scaffolds resulted in increased bone repair. The higher efficacy of the α-TCP scaffold suggests osteoconductive property that results in a biological support to the cells, whereas the GS scaffold functions just as a carrier. These results confirm the potential of ASCs in accelerating bone repair in in vivo experimental rat models. These results suggest a new alternative for treating bone defects.

Functional and radiological outcomes of a minimally invasive surgical approach to monostotic fibrous dysplasia

BackgroundReports showing high recurrence rates for intralesional curettage and bone grafting have made the current treatment principle for fibrous dysplasia controversial. This study aimed to report the postoperative clinical outcomes from three minimally invasive surgical strategies we use for monostotic fibrous dysplasia (MFD).Patients and methodsTwelve patients with MFD presenting with no pathologic fracture or deformity and treated with one of three surgical strategies—plain open biopsy, plain alpha-tricalcium phosphate (ATP) reconstruction, and prophylactic bridge plating—were included. There were nine men and three women, with median age of 38 years. Mean follow-up was 88 weeks. Five cases involved the proximal femur, two each involved the femoral and tibial diaphyses, and one each involved the distal humerus, radial diaphysis, and proximal tibia. All cases were reviewed for functional and radiological outcomes.ResultsMedian time to full activity was 1 day (range 1 to 3) for the plain open biopsy group, while the prophylactic bridge-plating and plain ATP reconstruction groups had longer median recovery times (59 days, range 3 to 143, and 52 days, range 11 to 192, respectively). Musculoskeletal Tumor Society scores at last follow-up were excellent for all the cases (mean 29.6, range 25 to 30). Radiological analysis using Gaski et al.’s criteria showed plain open biopsy resulted in partial resolution of proximal femoral lesions, while ATP reconstruction and prophylactic plating resulted in no change and progression in this lesion site, respectively. For femoral diaphyseal lesions, prophylactic plating resulted in partial resolution, while ATP reconstruction resulted in no change. In the tibial diaphysis, prophylactic plating resulted in partial resolution, while plain open biopsy resulted in no change. For the lesions involving the distal humerus and the proximal tibia, plain open biopsy resulted in partial resolution, while for the radial diaphyseal lesion, ATP reconstruction resulted in no change. Radiological progression was limited in 11 (92%) cases, and none had postoperative complications.ConclusionPlain open biopsies for asymptomatic lesions; prophylactic bridge plating for symptomatic, large diaphyseal lytic lesions; and plain ATP reconstructions for both small and large nondiaphyseal symptomatic lytic lesions may be acceptable alternatives to curettage-incorporating procedures for MFD.

Influence of different chemical treatments on the surface of Al2O3/ZrO2 nanocomposites during biomimetic coating

The objective of this study is to evaluate the influence of different chemical surface treatments (H3PO4, HNO3, and NaOH) in the formation of calcium phosphate phases on the surface of Al2O3/ZrO2 (5vol%) nanocomposite. For this purpose, Al2O3/ZrO2 samples were shaped, calcined at 400°C, sintered at 1500°C, subjected to different chemical treatments, and biomimetically coated from 14 to 21 days. Surface characterization was performed by scanning electron microscopy, atomic force microscopy, confocal microscopy, X-ray diffraction, and infrared spectroscopy. It was observed that the preliminary chemical treatment favored the formation of particular calcium phosphate phases of interest, such as α-TCP (alpha-tricalcium phosphate), β-TCP (beta-tricalcium phosphate), and HA (hydroxyapatite). The differences among the percentages of the phases formed affected the homogeneity of calcium phosphate distribution within the nanocomposites as well as the roughness of the formed layer, effectively contributing to adhesion, proliferation, and desired cell biofixation on bone implant.