Bone Conductivity Research Articles

Chitosan/Bioglass Nanocomposites for Bone Tissue Engineering and Regenerative Medicine: An Overview of Promising Biomaterials

: Bioactive glass (BG) shows great potential as a biomaterial for bone regeneration. Chitosan enhances the biological characteristics of BG. Chitosan is the sole commonly utilized natural polysaccharide that may be chemically altered for various purposes and roles. Composite materials formed by combining chitosan bioactive glass (BG) nanoparticles and microparticles are used in this context. Integrating bioactive glasses enhances the mechanical characteristics, bioactivity, and regenerative capacity of the end product. Research indicates that chitosan/BG composites enhance angiogenesis, cell adhesion, and proliferation. Bioglass improves biomineralization and boosts bone extracellular matrix formation by osteoblasts. The current findings demonstrate that the chitosan-glass nanofiber composites can enhance both antibacterial capabilities and bone conductivity. This review examines novel techniques for creating chitosan-based materials for engineering purposes, as well as upcoming difficulties and outlooks.

An Analysis of the Biocompatibility, Cytotoxicity, and Bone Conductivity of Polycaprolactone: An In Vivo Study.

Tissue engineering represents a promising field in regenerative medicine, with bioresorbable polymers such as polycaprolactone (PCL) playing a crucial role as scaffolds. These scaffolds support the growth and repair of tissues by mimicking the extracellular matrix. This study aimed to assess the in vivo performance of three-dimensional PCL scaffolds by evaluating their effects on bone repair in rat calvaria and the tissue reaction in subcutaneous implant sites, as well as their impact on major organs such as the kidneys, lungs, and liver. Three-dimensional scaffolds made of PCL were implanted in the subcutaneous tissue of rats' backs and calvaria. Histological analyses were conducted to observe the bone repair process in calvaria and the tissue response in subcutaneous implant sites. Additionally, the kidneys, lungs, and livers of the animals were examined for any adverse tissue alterations. The histological analysis of the bone repair in calvaria revealed newly formed bone growing towards the center of the defects. In subcutaneous tissues, a thin fibrous capsule with collagenous fibers enveloping the implant was observed in all animals, indicating a positive tissue response. Importantly, no harmful alterations or signs of inflammation, hyperplasia, metaplasia, dysplasia, or hemorrhage were detected in the kidneys, lungs, and liver. The findings demonstrate that PCL scaffolds produced through additive manufacturing are biocompatible, non-cytotoxic, and bioresorbable, promoting osteoconduction without adverse effects on major organs. Hence, PCL is confirmed as a suitable biomaterial for further studies in tissue engineering and regenerative medicine.

3D-printed HA15-loaded β-Tricalcium Phosphate/Poly (Lactic-co-glycolic acid) Bone Tissue Scaffold Promotes Bone Regeneration in Rabbit Radial Defects.

In this study, a β-tricalcium phosphate (β-TCP)/poly (lactic-co-glycolic acid) (PLGA) bone tissue scaffold was loaded with osteogenesis-promoting drug HA15 and constructed by three-dimensional (3D) printing technology. This drug delivery system with favorable biomechanical properties, bone conduction function, and local release of osteogenic drugs could provide the basis for the treatment of bone defects. The biomechanical properties of the scaffold were investigated by compressive testing, showing comparable biomechanical properties with cancellous bone tissue. Furthermore, the microstructure, pore morphology, and condition were studied. Moreover, the drug release concentration, the effect of anti-tuberculosis drugs in vitro and in rabbit radial defects, and the ability of the scaffold to repair the defects were studied. The results show that the scaffold loaded with HA15 can promote cell differentiation into osteoblasts in vitro, targeting HSPA5. The micro-computed tomography scans showed that after 12 weeks of scaffold implantation, the defect of the rabbit radius was repaired and the peripheral blood vessels were regenerated. Thus, HA15 can target HSPA5 to inhibit endoplasmic reticulum stress which finally leads to promotion of osteogenesis, bone regeneration, and angiogenesis in the rabbit bone defect model. Overall, the 3D-printed β-TCP/PLGA-loaded HA15 bone tissue scaffold can be used as a substitute material for the treatment of bone defects because of its unique biomechanical properties and bone conductivity.

Enhancing osteoblast proliferation and bone regeneration by poly (amino acid)/selenium-doped hydroxyapatite

Among various biomaterials employed for bone repair, composites with good biocompatibility and osteogenic ability had received increasing attention from biomedical applications. In this study, we doped selenium (Se) into hydroxyapatite (Se-HA) by the precipitation method, and prepared different amounts of Se-HA-loaded poly (amino acid)/Se-HA (PAA/Se-HA) composites (0, 10 wt%, 20 wt%, 30 wt%) by in-situ melting polycondensation. The physical and chemical properties of PAA/Se-HA composites were characterized by x-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), scanning electron microscopy (SEM) and their mechanical properties. XRD and FT-IR results showed that PAA/Se-HA composites contained characteristic peaks of PAA and Se-HA with amide linkage and HA structures. DSC and TGA results specified the PAA/Se-HA30 composite crystallization, melting, and maximum weight loss temperatures at 203.33 °C, 162.54 °C, and 468.92 °C, respectively, which implied good thermal stability. SEM results showed that Se-HA was uniformly dispersed in PAA. The mechanical properties of PAA/Se-HA30 composites included bending, compressive, and yield strengths at 83.07 ± 0.57, 106.56 ± 0.46, and 99.17 ± 1.11 MPa, respectively. The cellular responses of PAA/Se-HA composites in vitro were studied using bone marrow mesenchymal stem cells (BMSCs) by cell counting kit-8 assay, and results showed that PAA/Se-HA30 composites significantly promoted the proliferation of BMSCs at the concentration of 2 mg ml−1. The alkaline phosphatase activity (ALP) and alizarin red staining results showed that the introduction of Se-HA into PAA enhanced ALP activity and formation of calcium nodule. Western blotting and Real-time polymerase chain reaction results showed that the introduction of Se-HA into PAA could promoted the expression of osteogenic-related proteins and mRNA (integrin-binding sialoprotein, osteopontin, runt-related transcription factor 2 and Osterix) in BMSCs. A muscle defect at the back and a bone defect at the femoral condyle of New Zealand white rabbits were introduced for evaluating the enhancement of bone regeneration of PAA and PAA/Se-HA30 composites. The implantation of muscle tissue revealed good biocompatibility of PAA and PAA/Se-HA30 composites. The implantation of bone defect showed that PAA/Se-HA30 composites enhanced bone formation at the defect site (8 weeks), exhibiting good bone conductivity. Therefore, the PAA-based composite was a promising candidate material for bone tissue regeneration.

Application of metal-organic framework materials in regenerative medicine.

In the past few decades, scaffolds manufactured from composite or hybrid biomaterials of natural or synthetic origin have made great strides in enhancing wound healing and repairing fractures and pathological bone loss. However, the prevailing use of such scaffolds in tissue engineering is accompanied by numerous constraints, including low mechanical stability, poor biological activity, and impaired cell proliferation and differentiation. The performance of scaffolds in wound and bone tissue engineering may be enhanced by some modifications in the synthesis of nanoscale metal-organic framework (nano-MOF) scaffolds. Nano-MOFs have attracted researchers' attention in recent years due to their distinctive features, which include tenability, biocompatibility, good mechanical stability, and ultrahigh surface area. The biological properties of scaffolds are enhanced and tissue regeneration is facilitated by the introduction of nano-MOFs. Moreover, the physicochemical characteristics, drug loading, and ion release capacities of the scaffolds are improved by the nanoscale structure and topological features of nano-MOFs, which also control stem cell differentiation, proliferation, and attachment. This review provides further comprehensive detail about the most recent uses of nano-MOFs in tissue engineering. The distinct characteristics of nano-MOFs are explored in enhancing tissue repair, wound healing, osteoinduction, and bone conductivity. Significant attributes include high antibacterial activity, substantial drug-loading capacity, and the ability to regulate drug release. Finally, this discussion addresses the obstacles, clinical impediments, and considerations encountered in the application of these nanomaterials to diverse scaffolds, tissue-mimicking structures, dressings, fillers, and implants for bone tissue repair and wound healing.

Synthesis Technology of Magnesium-Doped Nanometer Hydroxyapatite: A Review.

Ion substitution techniques for nanoparticles have become an important neighborhood of biomedical engineering and have led to the development of innovative bioactive materials for health systems. Magnesium-doped nanohydroxyapatite (Mg-nHA) has good bone conductivity, biological activity, flexural strength, and fracture toughness due to particle doping technology, making it an ideal candidate material for biomedical applications. In this Review, we have systematically presented the synthesis methods of Mg-nHA and their application in the field of biomedical science and highlighted the pros and cons of each method. Finally, some future prospects for this important neighborhood are proposed. The purpose of this Review is to provide readers with an understanding of this new field of research on bioactive materials with innovative functions and systematically introduce the latest technologies for obtaining uniform, continuous, and morphologically diverse Mg-nHA.

Highly dense calcium phosphate ceramics prepared by self-hydration with hollow silicon calcium additives

Vertebral compression fractures are common nowadays. The application of calcium phosphate bone cement (CPCs) in the treatment of vertebral compression fractures is the research focus, because of its advantages of good biocompatibility, bone conductivity and injectability. However, it is still limited in the clinical application because of its poor mechanical properties. The main reason for the insufficient strength of CPC is that there are many defects inside the solidified body during the hydration reaction. Therefore, we design a kind of hollow silicon calcium additives to regulate the crystallization behavior of CPC hydration products in the self-curing process to achieve the densification of solidified bodies in the microstructure. Firstly, we plan to increase the nucleation site of hydration products during α-TCP hydration to fill structural defects by introducing hollow bioglass. Secondly, we prepare hollow calcium silicon additive by in situ mineralization which can dissolve calcium and silicon ions efficiently are used to regulate the local hydration microenvironment to reduce the crystal size and increase the number of hydration products to obtain a highly dense solidified body structure. The experimental results show that the initial hydration intensity of CPC increased from 18.36 ± 1.72 MPa to 35.37 ± 1.84 MPa, an increase of about 92.65 %. Also, the toughness of the solidified body has been greatly improved, reaching more than 200 %. After 7 days of hydration, the mechanical strength of CPC was further improved, reaching 89.39 ± 3.65 MPa. With the addition of hollow calcium silica additives, we achieved the conversion from calcium phosphate cement to the calcium phosphate ceramic. Our work provides reference value for the clinical replacement of calcium phosphate ceramic for PMMA in vertebral compression fractures.

Mineralized Collagen/Polylactic Acid Composite Scaffolds for Load-Bearing Bone Regeneration in a Developmental Model.

Repairing load-bearing bone defects in children remains a big clinical challenge. Mineralized collagen (MC) can effectively simulate natural bone composition and hierarchical structure and has a good biocompatibility and bone conductivity. Polylactic acid (PLA) is regarded as a gold material because of its mechanical properties and degradability. In this study, we prepare MC/PLA composite scaffolds via in situ mineralization and freeze-drying. Cell, characterization, and animal experiments compare and evaluate the biomimetic properties and repair effects of the MC/PLA scaffolds. Phalloidin and DAPI staining results show that the MC/PLA scaffolds are not cytotoxic. CCK-8 and scratch experiments prove that the scaffolds are superior to MC and hydroxyapatite (HA)/PLA scaffolds in promoting cell proliferation and migration. The surface and interior of the MC/PLA scaffolds exhibit rich interconnected pore structures with a porosity of ≥70%. The XRD patterns are typical HA waveforms. X-ray, micro-CT, and H&E staining reveal that the defect boundary disappears, new bone tissue grows into MC/PLA scaffolds in a large area, and the scaffolds are degraded after six months of implantation. The MC/PLA composite scaffold has a pore structure and composition similar to cancellous bone, with a good biocompatibility and bone regeneration ability.

Regulating the multifactor during wet chemical synthesis to obtain calcium phosphate powders with controllable phase purity for bone repair

Calcium phosphate ceramics are widely used as bone repair materials owing to their excellent biocompatibility, bone conductivity, bone induction, and degradability. Although there are many methods for synthesizing calcium phosphate and controlling its phase composition, it is necessary to explore effective preparation methods by understanding the formation of calcium phosphate and its influencing factors. In this study, calcium phosphate powders with controllable phase compositions were synthesized using a wet chemical precipitation method by adjusting the process parameters (aging time, bipolar solution, initial Ca-P molar ratio, capping agent concentration, and system concentration). Subsequently, a certain biphasic proportion of (biphasic calcium phosphate, BCP) products was prepared, and pure (β-tricalcium phosphate, β-TCP) can be obtained according to the customer's requirements. BCP ceramics with desired phase compositions were obtained by pressing and sintering different calcium-deficient powders. Specifically, β-TCP powder with a purity of 99.83 wt% was obtained when the aging time, bipolar solution, initial Ca-P molar ratio, capping agent concentration, and system concentration were 0 h, 50% ethanol, 1, 0.27 M, and 0.0135 M, respectively. The BCP synthesized in this study shows great application potential in the field of bone tissue repair materials.

Injectable Self-Setting Ternary Calcium-Based Bone Cement Promotes Bone Repair.

Bone defects, especially large ones, are clinically difficult to treat. The development of new bone repair materials exhibits broad application prospects in the clinical treatment of trauma. Bioceramics are considered to be one of the most promising biomaterials owing to their good biocompatibility and bone conductivity. In this study, a self-curing bone repair material having a controlled degradation rate was prepared by mixing calcium citrate, calcium hydrogen phosphate, and semi-hydrated calcium sulfate in varying proportions, and its properties were comprehensively evaluated. In vitro cell experiments and RNA sequencing showed that the composite cement activated PI3K/Akt and MAPK/Erk signaling pathways to promote osteogenesis by promoting the proliferation and osteoblastic differentiation of mesenchymal stem cells. In a rat model with femoral condyle defects, the composite bone cement showed excellent bone repair effect and promoted bone regeneration. The injectable properties of the composite cement further improved its practical applicability, and it can be applied in bone repair, especially in the repair of irregular bone defects, to achieve superior healing.

Preparation, modification, and clinical application of porous tantalum scaffolds.

Porous tantalum (Ta) implants have been developed and clinically applied as high-quality implant biomaterials in the orthopedics field because of their excellent corrosion resistance, biocompatibility, osteointegration, and bone conductivity. Porous Ta allows fine bone ingrowth and new bone formation through the inner space because of its high porosity and interconnected pore structure. It contributes to rapid bone integration and long-term stability of osseointegrated implants. Porous Ta has excellent wetting properties and high surface energy, which facilitate the adhesion, proliferation, and mineralization of osteoblasts. Moreover, porous Ta is superior to classical metallic materials in avoiding the stress shielding effect, minimizing the loss of marginal bone, and improving primary stability because of its low elastic modulus and high friction coefficient. Accordingly, the excellent biological and mechanical properties of porous Ta are primarily responsible for its rising clinical translation trend. Over the past 2decades, advanced fabrication strategies such as emerging manufacturing technologies, surface modification techniques, and patient-oriented designs have remarkably influenced the microstructural characteristic, bioactive performance, and clinical indications of porous Ta scaffolds. The present review offers an overview of the fabrication methods, modification techniques, and orthopedic applications of porous Ta implants.

Study on the Treatment and Repair of Fracture with Functional Composite Bone Adhesive

Compared with traditional internal fixation devices, bone adhesives have significant advantages in the treatment of bone injuries, such as improving the fixation of comminuted fractures and maintaining the spatial position of scattered bone fragments. By analyzing different kinds of bone adhesives, mechanical strength, osseointegration, bone conductivity, bone induction, application and two different research directions, this paper puts forward the concepts of "liquid stent" and "liquid plate” and discusses the research progress and future development trend of bone adhesives, in order to provide reference for clinical treatment and repair of fracture technology.

Research progress and clinical translation of three-dimensional printed porous tantalum in orthopaedics.

With continuous developments in additive manufacturing technology, tantalum (Ta) metal has been manufactured into orthopaedic implants with a variety of forms, properties and uses by three-dimensional printing. Based on extensive research in recent years, the design, processing and performance aspects of this new orthopaedic implant material have been greatly improved. Besides the bionic porous structure and mechanical characteristics that are similar to human bone tissue, porous tantalum is considered to be a viable bone repair material due to its outstanding corrosion resistance, biocompatibility, bone integration and bone conductivity. Numerous in vitro, in vivo, and clinical studies have been carried out in order to analyse the safety and efficacy of these implants in orthopaedic applications. This study reviews the most recent advances in manufacturing, characteristics and clinical application of porous tantalum materials.

Fabrication and properties of multi-functional polydopamine coated Cu/F-codoped hydroxyapatite hollow microspheres as drug carriers

Due to its excellent bone conductivity and drug adsorption as well as pH-responsive drug release property, hydroxyapatite (HAp) is widely used as a drug carrier in bone repair field. Here, we report for the first time a novel multi-functional polydopamine (PDA) coated Cu/F-codoped HAp (Cu/F-HAp-PDA) hollow microspheres. Both Cu2+ and F- were successfully doped into the lattice of HAp and uniformly distributed in the shell of hollow microspheres through a one-step hydrothermal synthesis. Then PDA was coated homogeneously on the outer layer of Cu/F-HAp hollow microspheres. Both Cu/F-HAp and Cu/F-HAp-PDA samples displayed high drug loading efficiency and pH responsive drug release behavior. Moreover, the obtained Cu/F-HAp-PDA hollow microspheres exhibited excellent photothermal conversion efficiency and photothermal stability. The molecular dynamics simulations showed that PDA and HAp can form mutual binding mainly through Ca-O bonding, while doxorubicin (DOX) is mainly bound to PDA molecules through hydrogen bonding and π-π stacking interaction.

Bone Regeneration with 3D-Printed Hybrid Bone Scaffolds in a Canine Radial Bone Defect Model.

The repair of large bone defects remains a significant challenge in clinical practice and requires bone grafts or substitute materials. In this study, we developed a unique hybrid bone scaffold comprising a three dimensional (3D)-printed metal plate for weight bearing and a biodegradable polymer tube serving as bone conduit. We assessed the long-term effect of the hybrid bone scaffold in repairing radial bone defects in a beagle model. Bone defects were created surgically on the radial bone of three beagle dogs and individually-tailored scaffolds were used for reconstruction with or without injection of autologous bone and decellularized extracellular matrix (dECM). The repaired tissue was evaluated by X-ray, micro-computed tomography, and histological observation 6months after surgery. The functional integrity of hybrid bone scaffold-mediated reconstructions was assessed by gait analysis. In vivo analysis showed that the hybrid bone scaffolds maintained the physical space and bone conductivity around the defect. New bone was formed adjacent to the scaffolds. Addition of autologous bone and dECM in the polymer tube improved healing by enhancing bone induction and osteoconduction. Furthermore, the beagles' gait appeared normal by 4months. The future of bone healing and regeneration is closely related to advances in tissue engineering. Bone production using autologous bone and dECM loaded on 3D-printed hybrid bone scaffolds can successfully induce osteogenesis and provide mechanical force for functional bone regeneration, even in large bone defects.

Customized Design 3D Printed PLGA/Calcium Sulfate Scaffold Enhances Mechanical and Biological Properties for Bone Regeneration

Polylactic glycolic acid copolymer (PLGA) has been widely used in tissue engineering due to its good biocompatibility and degradation properties. However, the mismatched mechanical and unsatisfactory biological properties of PLGA limit further application in bone tissue engineering. Calcium sulfate (CaSO4) is one of the most promising bone repair materials due to its non-immunogenicity, well biocompatibility, and excellent bone conductivity. In this study, aiming at the shortcomings of activity-lack and low mechanical of PLGA in bone tissue engineering, customized-designed 3D porous PLGA/CaSO4 scaffolds were prepared by 3D printing. We first studied the physical properties of PLGA/CaSO4 scaffolds and the results showed that CaSO4 improved the mechanical properties of PLGA scaffolds. In vitro experiments showed that PLGA/CaSO4 scaffold exhibited good biocompatibility. Moreover, the addition of CaSO4 could significantly improve the migration and osteogenic differentiation of MC3T3-E1 cells in the PLGA/CaSO4 scaffolds, and the PLGA/CaSO4 scaffolds made with 20 wt.% CaSO4 exhibited the best osteogenesis properties. Therefore, calcium sulfate was added to PLGA could lead to customized 3D printed scaffolds for enhanced mechanical properties and biological properties. The customized 3D-printed PLGA/CaSO4 scaffold shows great potential for precisely repairing irregular load-bearing bone defects.

Experimental study on the biocompatibility and osteogenesis induction ability of PLLA/DDM scaffolds.

To investigate the characterization and function of a novel porous osteogenic material (PLLA / DDM) containing polylactic acid and demineralized dentin matrix. The surface morphology and composition of the material were observed by SEM and EDS. The physical characteristics of the material were detected by roughness and water contact angle analyses. The rate of weight loss and change in the pH value of the material were observed by scaffold degradation experiments. Four types of material were investigated: polylactic acid (PLLA) scaffold, demineralized dentin matrix (DDM) particles, PLLA/DDM scaffold and a blank control. The osteogenic effect and osteogenic characteristics of the new materials were explored through in vivo and in vitro osteogenic experiments. SEM analysis showed that DDM powder was uniformly distributed in the polylactic acid scaffold, and the water contact angle revealed that the water absorption of the porous scaffold was improved after the addition of DDM powder. The EDS results showed that the peak values of calcium and phosphorus were obviously increased after the addition of DDM powder, and the porosity test showed that the scaffold had higher porosity after the addition of DDM powder. Scaffold degradation experiments revealed that the scaffold gradually degraded with increasing time, and its pH value slightly increased. The results of cell culture and animal model experiments showed that the porous PLLA/DDM scaffold had good bio-compatibility and promoted cell proliferation and differentiation. In histological and micro-CT evaluations, the material showed good bio-compatibility, biodegradability and bone conductivity with host bone tissue in vivo. PLLA / DDM hybrid showed better performance than PLLA or DDM. The biocompatibility and cell growth promoting properties were stronger than those of single material.

Enhanced bone formation in rat critical-size tibia defect by a novel quercetin-containing alpha-calcium sulphate hemihydrate/nano-hydroxyapatite composite

We developed an innovative method to include quercetin into alpha-calcium sulphate hemihydrate/nano-hydroxyapatite (α-CSH/n-HA), to prepare a novel quercetin-containing α-CSH/n-HA composite (Q-α-CSH/n-HA). The physicochemical properties, and ability of Q-α-CSH/n-HA to promote cell proliferation, migration, and osteogenic differentiation of bone marrow stem cells (BMSCs) in vitro were examined. Further, the potential of Q-α-CSH/n-HA to promote bone defect repair was studied using a Sprague-Dawley rat model of critical tibial defects. Imaging was conducted by radiography and micro-CT, and bone defect repairs were observed by histopathological staining. Addition of quercetin clearly increased the porosity of the degraded composite, which elevated the cell proliferation rate, migration ability, osteogenesis differentiation, and mineralisation of BMSCs. Further, quercetin-containing composite increased the expression levels of OSX, RUNX2, OCN, ALP, BMP-2, OPN, BSP, SMAD2, and TGF-β in BMSCs, while it downregulated TNF-α. X-ray and micro-CT imaging showed that the quercetin-containing composite significantly enhanced bone defect repair and new bone in formation. Haematoxylin and eosin, Goldner, and Safranin O staining also showed that quercetin significantly increased new bone generation and promoted composite degradation and absorption. Moreover, immunofluorescence assay revealed that quercetin significantly increased the number of RUNX2/OSX/OCN-positive cells. Overall, our data demonstrate that Q-α-CSH/n-HA has excellent biocompatibility, bone conductivity, and osteo-induction performance in vitro and mediates enhanced overall repair effects and bone reconstruction in vivo, indicating that it is a promising artificial bone graft to promote bone regeneration.

Chitosan-hydroxyapatite-MWCNTs nanocomposite patch for bone tissue engineering applications

Herein we study the structure, mechanical, electrical properties of chitosan-hydroxyapatite-multiwall carbon nanotubes (CS-HAp-MWCNT) films in a wide range of concentrations and their biocompatibility with human osteoblasts to develop a biocompatible flexible patch. Properties of nanocomposites are assessed by SEM, FTIR, mechanical, and impedance measurements. It was shown that all properties strongly depend upon the agglomeration of fillers due to particle-particle interactions and the chitosan matrix. Nanocomposite films with 5 wt% of HAp nanoparticles and 0.5 wt% of MWCNT exhibit superior mechanical properties and a conductivity that compares well with human bone conductivity, and good biocompatibility with human osteoblasts. Our results suggest the high potential application of the proposed nanocomposites for the development of a flexible patch for bone tissue engineering.

Biological Effects of Bioresorbable Materials in Alveolar Ridge Augmentation: Comparison of Early and Slow Resorbing Osteosynthesis Materials.

The purpose of this study was to investigate the bone healing properties and histological environment of a u-HA/PLLA/PGA (u-HA—uncalcined and unsintered hydroxyapatite, PLLA—Poly L-lactic acid, PGA—polyglycolic acid) composite device in humans, and to understand the histological dynamics of using this device for maxillofacial treatments. Twenty-one subjects underwent pre-implant maxillary alveolar ridge augmentation with mandibular cortical bone blocks using u-HA/PLLA or u-HA/PLLA/PGA screws for fixation. Six months later, specimens of these screws and their adjacent tissue were retrieved. A histological and immunohistochemical evaluation of these samples was performed using collagen 1a, ALP (alkaline phosphatase), and osteocalcin. We observed that alveolar bone augmentation was successful for all of the subjects. Upon histological evaluation, the u-HA/PLLA screws had merged with the bone components, and the bone was directly connected to the biomaterial. In contrast, direct bone connection was not observed for the u-HA/PLLA/PGA screw. Immunohistological findings showed that in the u-HA/PLLA group, collagen 1a was positive for fibers that penetrated vertically into the bone. Alkaline phosphatase was positive only in the u-HA/PLLA stroma, and the stroma was negative for osteocalcin. In this study, u-HA/PLLA showed a greater bioactive bone conductivity than u-HA/PLLA/PGA and a higher biocompatibility for direct bone attachment. Furthermore, u-HA/PLLA was shown to have the potential for bone formation in the stroma.