Bone Filler Research Articles

Synthesis and properties of tailored β‐tricalcium phosphate for bone filler applications

AbstractThe present work reports the synthesis of highly phase pure (> 95%) β‐TCP and its subsequent conversion into granules for bone graft applications, using an industrial scale proprietary manufacturing route. Following the wet chemical approach, several process parameters, were adjusted for large volume synthesis, including pH, precursor concentration, and ripening time. The granulation process is tailored to facilitate the scalibility and control over morphology, porosity, and pore size. X‐ray diffraction analysis confirms the presence of pure β‐TCP phase where as Ca/P molar ratio of 1.497 was determined using ICP‐OES. Fourier transform infrared spectroscopy depicts the presence of PO43− as a major molecular group. Scanning electron microscopy (SEM) images of the β‐TCP powders reveal necking features, a characteristic morphology of β‐TCP. SEM images of the β‐TCP granules reveal microporosity, which aids in triggering a biological response. The TGA‐DTA curve suggests that the weight loss in pure β‐TCP is twice as compared with β‐TCP containing hydroxyapatite. Furthermore, these β‐TCP granules were clinically tested in a few orthopedic and spine surgeries. In all the treated patients, β‐TCP granules did not induce any pus formation or infection at the surgical sites, thereby establishing clinically relevant biocompatibility properties.

Inflammatory Marker Changes Following Total Knee Arthroplasty for Rheumatoid Arthritis with Vancomycin-loaded Calcium Sulfate Bone Filling.

Rheumatoid arthritis (RA) patients undergoing total knee arthroplasty (TKA) face infection risk. The study evaluates vancomycin-loaded calcium sulfate bone as infection prevention. Patients with RA treated with TKA who had their femoral canal filled using either vancomycin-loaded calcium sulfate bone (experimental group [n = 35]) or the patient's own excised autologous bone (control group [n = 30]) at the Qingdao University Affiliated Hospital, Qingdao, China from January 1, 2017, to March 1, 2023, were retrospectively enrolled in this study. An experienced surgeon used midvastus approach. Surgeries included disinfection, antibiotics, and femoral filling. The age, gender, body mass index (BMI), comorbidities, and intraoperative details were extracted from the patient's medical records. Preoperation and postoperation markers (C-reactive protein [CRP], erythrocyte sedimentation rate [ESR]), pain scale (Visual Analog Scale [VAS]), infection rate, and Knee Society Score (KSS) were collected. Groups matched in age, gender, and BMI. No preoperative inflammatory marker differences were observed. However, compared to the control group, the postoperative inflammatory markers were significantly lower in the experimental group at 1-week postsurgery (CRP: 40.80 ± 23.17 vs. 60.80 ± 43.12 mg/L, p = 0.021; ESR: 72.06 ± 17.52 vs. 83.87 ± 21.52 mm/h, p = 0.012) and at 1-month postsurgery (CRP: 15.63 ± 6.56 vs. 21.17 ± 13.16 mg/L, p = 0.032; ESR: 25.25 ± 20.44 vs. 38.40 ± 25.26 mm/h, p = 0.024). There were no significant differences in the VAS (2.79 ± 0.90 vs. 2.70 ± 0.84 score, p = 0.689) and KSS (64.31 ± 17.88 vs. 66.57 ± 12.36) at 1-month postsurgery. Experimental group: zero infections; control group: only one infection. Administering vancomycin and calcium sulfate during TKA in RA patients reduces postoperative inflammation, but does not significantly affect infection risk; further research may be necessary for validation.

Dual cytokine release from microsphere-containing decellularized extracellular matrix immune regulation promotes bone repair and regeneration

Most bone filler materials currently achieve bone regeneration by mimicking the natural bone extracellular matrix. However, it is difficult for these materials to replicate the structural functions and bioactivities, including immunomodulation, of natural bone perfectly to reduce inflammation and promote bone regeneration synergistically. Repairing bone defects with scaffolds using a decellularised extracellular matrix (dECM) as a matrix material is an important clinical application and research direction. Here, we processed bovine cancellous bone via an optimised combination of decellularisation methods and preferred dECM, which has the shortest processing time and lowest immunogenicity. Hexagonal mesoporous silica (HMS)/poly(lactic-co-glycolic acid) (PLGA) microspheres loaded with bone morphogenetic protein-2 (BMP-2) were prepared using the complex emulsion method. The HMS/PLGA microspheres had longer cytokine release periods than did the separate HMS and PLGA microspheres. Composite BMP-2/HMS/PLGA microspheres were used to prepare dual-loaded cytokine scaffolds with bone immunomodulatory capacity, which were prepared from composite BMP-2/HMS/PLGA microspheres to increase the osteogenic activity of the dECM and to adsorb interleukin-4 (IL-4) on the surface of the scaffolds. The results showed that the dECM had good cytocompatibility and mechanical strength, and the composite microspheres and IL-4 further endowed the dECM with an ordered spatiotemporally controlled release function, which could release BMP-2 for more than 4 months in the long term and release IL-4 for approximately 10 days in the short term. The composite scaffold not only effectively promoted the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) but also immunomodulated the M1 to M2 polarisation of macrophages (MPs) and mediated the M2 polarisation of MPs, which in turn promoted the osteogenic differentiation of BMSCs, creating a favourable immune microenvironment for bone regeneration. In vivo, the dual drug-loaded scaffolds also exhibited good biocompatibility and significantly superior immunomodulatory bone-enhancing properties compared with those of the other groups. In summary, the combination of dECM scaffolds with cytokine-carrying microspheres and immunomodulatory factors can promote the orderly spatiotemporal release of cytokines, which significantly enhances the bone regeneration and repair effects of dECM scaffolds and is a promising bone filler material for clinical application.

Development of in situ forming autologous fibrin scaffold incorporating synthetic teriparatide peptide for bone tissue engineering.

This study investigates the potential of an in-situ forming scaffold using a fibrin-based scaffold derived from autologous plasma combined with Synthetic Teriparatide (TP) for bone regeneration application. TP is known for its bone formation stimulation but has limited clinical use due to side effects. This autologous delivery system aims to provide precise, controlled, localized, and long-term release of TP for accelerating bone regeneration. Fibrinogen from autologous plasma was extracted using ethanol, and thrombin was precipitated with ammonium sulfate to create the fibrin scaffold. Characterization of fibrinogen was done through FTIR, SDS-Page, porosity, SEM, degradation, and rheology tests. Viability was assessed by MTT in five groups with different concentrations of TP in fibrin scaffold (50, 100, and 150 µl/ml), fibrin alone, and a control group against HEK and Wharton's jelly cells. The release profile of different concentrations of TP in the fibrin scaffold was also examined. The formation time of the fibrin scaffold was 4 ± 0.2 s. The highest Infrared absorption for fibrinogen was confirmed. Rheology assessment revealed a higher elastic modulus than the viscous modulus. The created fibrin scaffold displayed a consistent three-dimensional microstructure with an interconnected porous network. Cytotoxicity assays demonstrated good biocompatibility and enhanced cell growth with different concentrations of TP in the fibrin scaffold. The TP release increased with higher concentrations, peaking at an average of 61% over 54 h. Autologous plasma-derived fibrin scaffolds incorporating TP exhibit satisfactory release within the scaffold and hold promise as a versatile bone filler for clinical use, facilitating osteoregeneration.

Development of calcium phosphate cement composed of silica-modified hydroxyapatite, cerium oxide, and silica as an osteoporotic bone filler

Calcium phosphate cement (CPC), composed of silica-modified hydroxyapatite (HA-SiO2), cerium oxide (CeO2), and silica (SiO2), was developed as an osteoporosis bone filler. The effect of CeO2 and SiO2 content on the CPC's properties, such as crystal parameters, surface properties, antibacterial activity, and toxicity properties, were studied. HA-SiO2 was prepared using the sol-gel method, while CeO2 was prepared using the precipitation method. HA in HA-SiO2 has crystal properties similar to pure HA. Synthesized CeO2 contains Ce3+ and Ce4+ ions with Ce3+/Ce4+ = 0.34. Computational calculation predicted that the CeO2 (111) surface and glycine molecule interaction was categorized as chemisorption. Moreover, CeO2 has antibacterial activity toward Escherichia coli and Staphylococcus aureus. Combining HA-SiO2 and CeO2 did not change the adsorption-desorption isotherm curve type, but slightly decreased the surface area, total pore volume, and average pore. Increasing the percentage of CeO2 and adding 10 % SiO2 (w/w) affected the particle's size and CeO2 distribution. However, CPC lost antibacterial activity toward Staphylococcus aureus but adding 10 % SiO2 (w/w) increases the bacterial activity toward Escherichia coli close to that of pure CeO2. The MTT assay using pre-osteoblast MC3T3E1 cells showed that the CPC has IC50 = 4227 μg/ml or is nontoxic.

In Vitro and In Vivo Biological Properties of Calcium Silicophosphate-Based Bone Grafts: Silicocarnotite and Nagelschmidtite.

Accidents, trauma, bone defects, and oncological processes significantly impact patients' health and quality of life. While calcium phosphates and bioactive glasses are commonly used as bone fillers to facilitate bone regeneration in orthopedics and traumatology, they exhibit certain disadvantages compared to calcium silicophosphate phases. This study evaluates the in vitro cytocompatibility and in vivo osteogenic properties of two-third-generation ceramic phases: silicocarnotite (SC) and nagelschmidtite (Nagel). These phases were synthesized via a solid-state reaction and characterized using X-ray diffraction and scanning electron microscopy. In vitro behavior was assessed through bioactivity tests, cell viability, proliferation, and inflammatory profiles by detecting cytokines and reactive oxygen species. Osteogenic properties were evaluated by detecting bone-associated proteins in MG-G3, hFOB1.19, and MC3T3-E1 cell lines after 3, 7, and 14 days. 45S5 Bioactive glass (BG), hydroxyapatite (HAp), and osteogenic medium were employed as control standards for bone formation. SC and Nagel phases exhibited higher viability percentages as well as osteoconductive and osteoinductive behavior. Finally, SC and Nagel bone grafts were implanted in a Wistar rat model to assess their in vivo ability to induce bone formation, demonstrating complete osseointegration after 12 weeks. Histological evaluation revealed osteocytes forming osteons and the presence of blood vessels, particularly in rats implanted with Nagel. Given their favorable biological performance, SC and Nagel emerge as promising candidates for bone grafts in orthopedics, traumatology, and maxillofacial surgery.

Development of Ductile‐Sticky Bone Fillers from Biodegradable Hydrolyzed Wool‐Keratin and Silk Fibroin

AbstractIn the present study, a method is proposed for preparing novel ductile‐sticky materials that can be used as bone void fillers using hydrolyzed wool‐keratin (WK) and silk fibroin (SF). This methodology uses citric acid as a cross‐linking agent in preparing keratin paste (KP) owing to its non‐toxicity and plasticizing properties. The Keratin paste‐silk fibroin structure (KPSF) is obtained by adding SF, which possesses biocompatible and superior mechanical properties. Methanol treatment is employed on the KPSF mixture to convert the Silk I structure in the SF to Silk II, resulting in a water‐insoluble and tightly packed proteinaceous structure. The physicochemical properties of both bioscaffolds are investigated and discussed in detail by comparison. Based on the findings, the presence of SF in the KPSF structure contributed to properties such as flexibility and porosity. In ovo CAM analysis reveals that both materials exhibit proangiogenic properties and are biocompatible. KP and KPSF bioscaffolds can be converted into ductile‐sticky forms by adding water. It believes that these forms can easily apply to bone defect areas, particularly cavitary bone defects. Furthermore, KPSF bioscaffolds, with better mechanical properties, can be considered candidates for use in non‐load‐bearing bone tissue engineering applications.

Anti-Bacterial and Anti-Inflammatory Effects of a Ceramic Bone Filler Containing Polyphenols from Grape Pomace

Anti-Bacterial and Anti-Inflammatory Effects of a Ceramic Bone Filler Containing Polyphenols from Grape Pomace

Nano-cockle shell powder and alginate as novel injectable bone filler: A preliminary formulation and characterization study

Nano-cockle shell powder and alginate as novel injectable bone filler: A preliminary formulation and characterization study

Bioselective and Radiopaque Zinc-Biopolymeric Complex-Based Porous Biomaterials Promote Mammalian Tissue Ingrowth In Vivo While Inhibiting Microbial Biofilm Gene Expression and Biofilm Formation.

Metal-organic complexes have shown astounding bioactive properties; however, they are rarely explored as biomaterials. Recent studies showed that carboxymethyl-chitosan (CMC) genipin-conjugated zinc biomimetic scaffolds have unique bioselective properties. The biomaterial was reported to be mammalian cell-friendly; at the same time, it was found to discourage microbial biofilm formation on its surface, which seemed to be a promising solution to addressing the problem of trauma-associated biofilm formation and development of antimicrobial resistance. However, the mechanically frail characteristics and zinc overload raise concerns and limit the potential of the said biomaterials. Hence, the present work is focused on improving the strength of the earlier scaffold formulations, testing its in vivo efficacy and reaffirming its action against biofilm-forming microbe Staphylococcus aureus. Scaling up of CMC proportion increased rigidity, and 8% CMC was found to be the ideal concentration for robust scaffold fabrication. Freeze-dried CMC scaffolds with or without genipin (GP) cross-linking were conjugated with zinc using 2 M zinc acetate solution. Characterization results indicated that the CMC-Zn scaffolds, without genipin, showed mechanical properties close to bone fillers, resist in vitro enzymatic degradation until 4 weeks, are porous in nature, and have radiopacity close to mandibular bones. Upon implantation in a subcutaneous pocket of Wistar rats, the scaffolds showed tissue in-growth with simultaneous degradation without any signs of toxicity past 28 days. Neither were there any signs of toxicity in any of the vital organs. Considering many superior properties among the other formulations, the CMC-Zn scaffolds were furthered for biofilm studies. CMC-Zn showed negligible S. aureus biofilm formation on its surface as revealed by an alamar blue-based study. RT-PCR analysis revealed that CMC-Zn downregulated the expression of pro-biofilm effector genes such as icaC and clfB. A protein docking study predicted the inhibitory mechanism of CMC-Zn. Although it binds strongly when alone, at high density, it may cause inactivation of the transmembrane upstream activators of the said genes, thereby preventing their dimerization and subsequent inactivation of the effector genes. In conclusion, zinc-conjugated carboxymethyl-chitosan scaffolds are mechanically robust, porous, yet biodegradable, harmless to the host in the long term, they are radiopaque and prevent biofilm gene expression in notorious microbes; hence, they could be a suitable candidate for bone filler applications.

Efficacy of sintered Zinc-doped fluorapatite scaffold as an antimicrobial regenerative bone filler for dental applications

ObjectivesThe objective of this study was to assess whether zinc-doped fluorapatite (ZnFA) could serve as an effective antimicrobial dental bone filler for bone regeneration compared to autografts. MethodsFA and 2 % zinc-doped FA (2ZnFA) were synthesized and characterized in-house. Compressed and sintered FA and 2ZnFA disks were incubated with bacteria to assess antimicrobial properties. Adipose-derived stem cells were cultured on these discs to evaluate the surfaces’ ability to support cell growth and promote osteogenic differentiation. Surfaces exhibiting the highest expressions of the bone markers osteopontin and osteocalcin were selected for an in vivo study in a rat mandibular defect model. Twenty rats were divided into 5 groups, equally, and a 5 mm surgical defect of the jaw was left untreated or filled with 2ZnFA, FA, autograft, or demineralized bone matrix (DBM). At 12 weeks, the defects and surrounding tissues were harvested and subjected to microCT and histological evaluations. ResultsStandard techniques such as FTIR, ICP-MS, fluoride probe, and XRD revealed the sintered FA and ZnFA's chemical compositions and structures. Bacterial studies revealed no significant differences in surface bacterial adhesion properties between FA and 2ZnFA, but significantly fewer bacterial loads than control titanium discs (p < 0.05). Cell culture data confirmed that both surfaces could support cell growth and promote the osteogenic differentiation of stem cells. MicroCT analysis confirmed statistical similarities in bone regeneration within FA, 2ZnFA, and autograft groups. ConclusionThe data suggests that both FA and 2ZnFA could serve as alternatives to autograft materials, which are the current gold standard. Moreover, these bone fillers outperformed DBM, an allograft material commonly used as a dental bone void filler. Clinical SignificanceThe use of FA or 2ZnFA for treating mandibular defects led to bone regeneration statistically similar to autograft repair and significantly outperformed the widely used dental bone filler, DBM. Additional translational research may confirm FA-based materials as superior substitutes for existing synthetic bone fillers, ultimately enhancing patient outcomes.

A metamaterial bone plate for biofixation based on 3D printing technology

Bone plate design and production methods are critical for producing metamaterial bone plates. This study investigated the design and development process of porous structures and metamaterial bone plates for biofixation applications. We designed the porous structures for bone plates using parametric modeling and fused them via the implicit surface fusion method. Likewise, we designed the metamaterial bone plate structure using reverse reconstruction and topological optimization. Thereafter, we utilized three-dimensional (3D) printing for producing and post-processing the metamaterial bone plate. We observed a reduced stress-shielding effect after topological optimization. Additionally, the resultant diamond porous structure maintained a high porosity under pressure. The 3D-printed bone plates and fillers had a bright porous surface, with clear pore structures and good connectivity. The assembly of the 3D-printed femur, bone plate, filler, and standardized screw indicated a good fitting, and the filler could be fixed by the inclined surface. Taken together, the findings of this study established the foundation for the prospective application of metamaterial bone plates in biofixation.

Comparison of different bone substitutes in the repair of rat calvaria critical size defects: questioning the need for alveolar ridge presentation.

This study aimed to evaluate the effectiveness of biomaterials in bone healing of critical bone defects created by piezoelectric surgery in rat calvaria. Histomorphologic analysis was performed to assess bone regeneration and tissue response. Fifty animals were randomized into five groups with one of the following treatments: Control group (n = 10), spontaneous blood clot formation with no bone fill; BO group (Bio-Oss, Geistlich Pharma; n = 10), defects were filled with bovine medullary bone substitute; BF group (Bonefill, Bionnovation; n = 10), defects were filled with bovine cortical bone substitute; hydroxyapatite group (n = 10), defects were filled with hydroxyapatite; calcium sulfate group (n = 10), defects were filled with calcium sulfate. Five animals from each group were euthanized at 30 and 45 days. The histomorphometry calculated the percentage of the new bone formation in the bone defect. All data obtained were evaluated statistically considering P < .05 as statistically significant. The results demonstrated the potential of all biomaterials for enhancing bone regeneration. The findings showed no statistical differences between all the biomaterials at 30 and 45 days including the control group without bone grafting. In conclusion, the tested biomaterials presented an estimated capacity of osteoconduction, statistically nonsignificant between them. In addition, the selection of biomaterial should consider the specific clinical aspect, resorption rates, size of the particle, and desired bone healing responses. It is important to emphasize that in some cases, using no bone filler might provide comparable results with reduced cost and possible complications questioning the very frequent use of ridge presentation procedures.

Synthesis and characterisations of clinoptilolite enriched hydroxyapatite nanoceramics by sol-gel route for bone regeneration

Hydroxyapatite (HA) has great bioactive potential in bone tissue engineering (BTE). However, the high crystalline stability of synthetic HA restricts its in-vivo bioresorbability which extends the healing time of bone defects. This study investigates doping HA with biocompatible Clinoptilolite (CLP) mineral rich in silicate and other biomimetic ions (Na+, K+, Ca+2, Mg+2 etc.). Sol-gel-based CLP doped HA nanoceramics are aimed to be exploited as bone filler substitutes with biomimetic morphology, composition, and improved biocompatibility and bioactivity. The pure and CLP (5%, 10% and 20%) doped HA ceramics were synthesised by sol-gel method to provide molecular level interactions of ions and sintered at different temperatures (800 °C, 950 °C, and 1100 °C). Morphological analyses by SEM and S-TEM showed biomimetic nano rod-like HA particles are attached to dispersed CLP sheets. Sintering of composite ceramics led to a cell-friendly interconnected porous microstructure even at 1100 °C, where the pure HA had a compact non-porous structure. The Ca/P ratio of CLP-doped HA samples was lower than the stoichiometric HA which indicates a partial reduction of stability that is supposed to induce bioresorption capacity. Cytotoxicity tests by WST-8 with Saos-2 cell lines showed that CLP addition into HA has significantly improved cell viability. The HA-CLP nanoceramics are expected to promote bone regeneration due to cell-friendly microstructure and biomimetic composition which can be supported by further in-vivo clinical studies.

Designing and synthesis of In-Situ hydrogel based on pullulan/carboxymethyl chitosan containing parathyroid hormone for bone tissue engineering

There has been some confusion in daily life regarding craniofacial bone defects caused by aging, malignant lesions, or trauma. Injectable hydrogels have emerged as a promising method for healing bone defects and accelerating regeneration. In this study, we initiated the conversion of Chitosan (CS) to Carboxymethyl Chitosan (CMCS), followed by Pullulan (PL) to Pullulan Oxide (OPL). A rapidly in situ forming injectable oxidized carboxymethyl chitosan/pullulan (CMCS/OPL) hydrogel was developed through crosslinking. Additionally, to enhance osteogenesis, Parathyroid Hormone (PTH) was loaded into CMCS/OPL to obtain the (CMCS/OPL/PTH) hydrogel.In vitro evaluations involved the examination of sample structure and biological features through FTIR, SEM, swelling test, degradation test, PTH release, rheological behavior, MTT, live & dead assay, and alizarin Red S test. The results confirmed the successful creation of the Schiff base reaction. Notably, the hydrogel exhibited appropriate viscosity, porosity exceeding 90 %, and suitable degradation over 28 days accompanied by a continuous peptide release in both groups. Cell morphology and biocompatibility were favorable, with cell proliferation on day 7 in the CMCS/OPL/PTH hydrogel matching that of the control group. Furthermore, calcium deposition in the CMCS/OPL/PTH hydrogel after 21 days exceeded that in the group without PTH. Inspired by these results, the hydrogel was implanted into the mandibular bone defect in Sprague-Dawley rats. The in vivo study revealed accelerated bone regeneration and angiogenesis attributed to the rapid gelation rate and sustained release of PTH. In conclusion, this in-situ forming hydrogel exhibits considerable potential as a universal bone filler in clinical applications, facilitating osteoregeneration.

Synthesis and characterization of hydroxyapatite self-assembled nanocomposites on graphene oxide sheets from seashell waste: A green process for regenerative medicine

Bone transplantation is the second most common transplantation surgery in the world. Therefore, there is an urgent need for artificial bone transplantation to repair bone defects. In bone tissue engineering, hydroxyapatite (HA) plays a major role in bone graft applications. This study deals with a facile method for synthesizing HA hexagonal nanorods from seashells by a solid-state hydrothermal transition process. The synthesized HA nanorods (∼2.29 nm) were reinforced with carbon nanotube and chitosan on graphene oxide sheets with polymeric support by in-situ synthetic approach. Among the synthesized nanocomposites viz., hydroxyapatite-graphene oxide (HA-GO), hydroxyapatite-graphene oxide-chitosan (HA-GO-CS), hydroxyapatite-graphene oxide-chitosan-carbon nanotube-polylactic acid (HA-GO–CS–CNT-PLA). Among them, the HA-GO–CS–CNT-PLA composite exhibits micro and macro porosity (∼200 to 600 μm), higher mechanical strength, (Hardness ∼90.5 ± 1.33 MPa; Tensile strength 25.62 MPa), and maximum cell viability in MG63 osteoblast-like cells (80%). The self-assembled hybrid-nanocomposite of HA-GO–CS–CNT-PLA is a promising material for bone filler application and could efficiently utilize seashell waste through the green process.

Bio-inspired liquid crystal gel induction via nano-hydroxyapatite mesogens: Viscoelastic and hemostasis regulation under bone remodeling pH and temperature control

In this work, a liquid crystal mesophase as a potential bone-repairing booster has been induced from a polyacrylic acid (PAAc) gel loaded with synthetic hydroxyapatite nanoparticles (nHA) under physiological conditions of pH and temperature that resemble the early stages of bone formation. Dynamic processes at the microscale in biological systems require a material capable of behaving following a specific order and fluency. Besides, they must fulfill conditions such as biocompatibility and good mechanical properties. Our study aimed to obtain new data about the safety, hemostasis, biocompatibility (activated partial thromboplastin time (APTT) test, prothrombin time (PT) test, lactate dehydrogenase (LDH) test, red blood cell morphology observation, hemolysis percentage) and physicochemical/mechanical behavior (Attenuated Total Reflection (ATR), Infrared spectroscopy and rheological assays) of nanoparticles, and materials built with them. Both systems have shown biocompatibility with red blood cells and adequate flow properties, demonstrating promising qualities for applicability. The formation of lyotropic liquid crystals at physiological conditions was evaluated with crossed polaroids microscope with a temperature control plate. The formation of these structures under bone remodeling conditions shows the potential application of PAAc-nHA materials. In literature, the study of materials applied as bone fillers is mainly focused on mechanical and osteoblasts compatibility assays. However, the hematological effect, consequences on the coagulation cascade, the integrity of cell membranes, and hemolysis percentage have not been addressed thoroughly. The strength of our work is focused on considering these aspects when tridimensional arrangements essential for bone formation are formed.

Comparison of Orthodontic Tooth Movement of Regenerated Bone Induced by Carbonated Hydroxyapatite or Deproteinized Bovine Bone Mineral in Beagle Dogs.

Orthodontic treatments often involve tooth movement to improve dental alignment. In this study, we aimed to compare tooth movement in regenerated bone induced by two different bone fillers, carbonated hydroxyapatite (CAP) and deproteinized bovine bone mineral (DBBM). Four beagle dogs were used in this comparative study. The first, second, and fourth lower mandibular premolars (P1, P2, and P4) on both sides of the mouth were extracted, and CAP was implanted into the extraction site on the left side and DBBM into the right side. Following regenerative bone healing, orthodontic devices were attached to perform orthodontic tooth movement of the lower third mandibular premolar (P3) on both sides. X-ray examination, intraoral scan, and histological analysis were performed. The Mann-Whitney U test was used for statistical analysis, and p < 0.05 was considered significant. Bone regeneration and orthodontic tooth movement were observed in the CAP and DBBM groups. Histologically, normal periodontal tissue remodeling was observed on the compression and tension sides of CAP and DBBM. No statistical difference was observed in the number of osteoclasts around the periodontal ligament and the root resorption area. Orthodontic tooth movement of regenerated bone induced by CAP and DBBM was therefore achieved.

Characterization and Synthesis Hydroxyapatite from Scallop Mussel Shells Prepared by the Microwave-Assisted Precipitation Methods

The need for bone implants is constantly increasing every year as the population of older people, accidents, and bone diseases increase. Various solutions, such as autograft, allograft, and artificial endoprosthesis, have been developed by researchers. Ceramic or bio-ceramic materials become very attractive as bone implants due to their high biocompatibility. One of the most commonly used bio-ceramics today is hydroxyapatite (HAp). Hydroxyapatite is one of the biomaterials that are widely used as biomedical materials, such as bone fillers, bioactive implant coatings, bone tissue repair systems and drug distribution. Kabupaten Gresik is famous for its fisheries, including the scallop mussel shells. The scallop mussel shells (Ruditapes philippinarum) is a species of shells that is widely cultivated in the Kabupaten Gresik. Using scallop mussel shell wastes as hydroxyapatite raw material can reduce shell waste volumes and production costs. Several methods for producing hydroxyapatites include hydrothermal, sol-gel, mechanochemical, wet chemical and microwave methods. Hydroxyapatite synthesis with the microwave method has the advantages of efficient heating, environmentally friendly and economical. This study aims to characterize and synthesize hydroxyapatite using scallop mussel shell waste prepared using microwave-assisted precipitation methods in the Gresik Regency. The research was carried out to convert the scallop mussel shells resulting from calcination with the crystal phase Ca(OH)2 into hydroxyapatite using the microwave method. The synthesis process with the method of microwaves at the power of 450 watts for 2.5 minutes. From the synthesis results, hydroxyapatite was then characterized by XRD and SEM tests. The XRD tests carried out formed 99.1% crystallinity of hydroxyapatite.

Evaluating the Necessity of Screw Replacement in Sacral Bone Loosening: A Minimally Invasive Approach for Treatment with Local Anesthesia

Abstract Background This study aimed to investigate a minimally invasive approach to address the issue of bone loosening in patients who have undergone posterior spinal fusion surgery. If left untreated, sacral bone loosening can result in nerve damage, reduced mobility, and chronic pain. The standard surgical treatment involves replacing the loosened screw with a larger one, requiring significant surgical intervention and complete instrument disassembly. The use of polymethylmethacrylate (PMMA) to increase the strength of the vertebral body was also described, but the results were contradictory. We aim to evaluate the efficacy of filling just only the gap between bone and screw instead of the vertebral body. Methods This study included patients who had undergone posterior transpedicular stabilization but showed signs of sacral bone loosening in follow-up. The gap between the screw and the bone was targeted instead of the vertebral body and filled using PMMA. The procedure was performed under local anesthesia and fluoroscopy, and the preoperative and postoperative visual analog scale (VAS) scores were compared at 1, 3, and 12 months after the procedure. Results The study included 17 patients who underwent 28 procedures, with 11 patients receiving bilateral and 6 receiving unilateral approaches. The results showed a significant decrease in postoperative VAS scores compared to the preoperative scores, indicating reduced pain and discomfort. PMMA, as a bone filler, has been reported to provide good stability and support to the bone-implant interface, thereby reducing the risk of screw loosening and improving the outcome of spinal fusion surgery. Conclusion In conclusion, the study demonstrates the efficacy of a minimally invasive approach using PMMA to treat sacral bone loosening in patients who have undergone posterior spinal fusion surgery. The procedure is safe, minimally invasive, and provides significant pain relief, making it a viable alternative to traditional surgical methods.