Non-operated Bone Research Articles

The Role of Strontium Enriched Hydroxyapatite and Tricalcium Phosphate Biomaterials in Osteoporotic Bone Regeneration

Background: Strontium (Sr) enriched biomaterials have been used to improve bone regeneration in vivo. However, most studies provide only two experimental groups. The aim of our study was to compare eleven different bone sample groups from osteoporotic and healthy rabbits’ femoral neck, as it is the most frequent osteoporotic fracture in humans. Methods: Osteoporotic bone defects were filled with hydroxyapatite 30% (HA) and tricalcium phosphate 70% (TCP), 5% Sr-enriched HA30/TCP70, HA70/TCP30, or Sr-HA70/TCP30 granules and were compared with intact leg, sham surgery and healthy non-operated bone. Expression of osteoprotegerin (OPG), nuclear factor kappa beta 105 (NFkB-105), osteocalcin (OC), bone morphogenetic protein 2/4 (BMP-2/4), collagen I (Col-1α), matrix metalloproteinase 2 (MMP-2), tissue inhibitor of matrix metalloproteinase 2 (TIMP-2), interleukin 1 (IL-1) and interleukin 10 (IL-10) was analyzed by histomorphometry and immunohistochemistry. Results: Our study showed that Sr-HA70/TCP30 induced higher expression of all above-mentioned factors compared to intact leg and even higher expression of OC, MMP-2 and NFkB-105 compared to Sr-HA30/TCP70. HA70/TCP30 induced higher level of NFkB-105 and IL-1 compared to HA30/TCP70. Conclusion: Sr-enriched biomaterials improved bone regeneration at molecular level in severe osteoporosis and induced activity of the factors was higher than after pure ceramic, sham or even healthy rabbits.

Sclerostin Antibody Treatment Increases Bone Formation, Bone Mass, and Bone Strength of Intact Bones in Adult Male Rats.

We investigated the systemic effect of sclerostin monoclonal antibody (Scl-Ab) treatment on intact non-operated bones in an open osteotomy male Sprague Dawley (SD) rat model. Six-month-old male SD rats were subjected to transverse osteotomy at the right femur mid-shaft. Rats were injected subcutaneously with vehicle or Scl-Ab (25 mg/kg, 2 times per week) treatment for 9 weeks. Compared with vehicle control, Scl-Ab treatment significantly improved trabecular and cortical bone mass and microarchitecture at L5 vertebrae and left femora by micro-CT at week 6 and 9. Mechanical testing showed that Scl-Ab treatment resulted in significantly higher stiffness, energy to failure and ultimate load at the femora at week 9. Mineral apposition rate, mineralizing surface and bone formation rate on the trabecular bone in the distal femora was significantly increased in Scl-Ab group at week 6 and 9. The administered Scl-Ab was localized in the osteocytes and beta-catenin was strongly expressed in osteoblasts. Scl-Ab treatment significantly increased serum P1NP level and there was no between-group difference in serum level of CTX-1. In conclusion, Scl-Ab treatment could induce rapid and sustained increase in bone formation, bone mass and bone strength in non-operated bones. Sclerostin inhibition might be advantageous to prevent secondary fracture(s).

Use of screw locking elements improves radiological and biomechanical results of femoral osteotomies.

BackgroundDynamic compression plate (DCP) constructs provide inadequate fixation in cases of poor bone quality and early weight-bearing. Screw locking elements (SLE) are flat locking nuts placed at the end of the screw to prevent screw stripping from the bone, improving fixation stability. The purpose of this work was to compare biomechanical and radiological evaluations of femoral ovine osteotomies fixed using DCP constructs with and without SLE.MethodA dyaphyseal femoral osteotomy was performed in sixteen adult sheep and fixed with a DCP and cortical screws. Half of the animals were operated on with a SLE on each side of the osteotomy and the rest without the addition of SLE. Four animals of each group were euthanized after 8 weeks, and the remaining after 16 weeks. Both femora of each animal were radiographed and mechanically tested in torsion.ResultsRadiologically femoral malalignment or screw loosening was observed in six out of the eight animals operated on without SLE. In contrast, all animals subjected to the operation with SLE showed complete radiological consolidation of the osteotomy. Seven of these eight animals showed normal femoral alignment and no osteosynthesis failure. Stiffness of the bones fixed with SLE was among 145% and 177% the value of their contralateral non-operated femurs (all animals of this group showed greater stiffness on the operated bone than its contralateral non-operated femur). However, stiffness of the bones operated on without SLE was among 58% and 87% the value of the stiffness of their contralateral non-operated bone (all animals of this group showed greater stiffness on the non-operated bone than the osteotomized ones).ConclusionsUse of SLE avoided loosening of the system and stimulated stronger osteotomy consolidation. Clinical application of this improved system may thus be a feasible and cost-effective alternative to other more rigid and expensive bone fixation techniques.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-387) contains supplementary material, which is available to authorized users.

Tongue Flaps for Closure of Large Palatal Fistulas in Cleft Lip and Palate Patients

matic implants were inserted in the healthy non-operated bone, extending the body of fixture into the poor bone quality area. The zygomatic implant was used to bypass the junction site between the well-vascularized bone and the grafting emerging 5 to 10 mm away from the bony union, into the grafting area. Regular dental implants were used to complete the anchorage in the mandibular body to allow proper distribution and adequate biomechanics utilizing hybrid screw retained prosthesis. The short zygoma implants were utilized as replacement of the inclined lateral fixtures in the all-on-4 concept. Method of Data Analysis: All patient s records included clinical, radiographs and photographs analysis, preand postoperative; all patients were followed for a minimum of 12 months. Also, prosthodontist and surgeon clinical evaluations were obtained and charts filled with information on dental occlusion, range of mandibular motion, tissue health around fixtures, level of the implant related to soft tissue, rehabilitation stability, hygiene, nasal airway and patient satisfaction. Results: All patients were dentally rehabilitated immediately with functional and esthetic hybrid dentures based on either acrylic or porcelain on a metal structure, using 37 zygomatic implants and 40 standard fixtures. Immediate provisional prosthesis was installed intra-operatively using provisional abutments. Patients were instructed to maintain excellent hygiene and periodontal control every 3 months. Conclusions: All patients were adequately rehabilitated, avoiding the need of new major grafting or distraction osteogenesis. This group of patients represents a major challenge after the initial reconstruction, where there is bone continuity, but the quality was unacceptable for standard dental implants; secondary surgeries in the compromised hostage bone would compromise the final outcome and would require further unpredictable surgeries. The zygoma fixture is an excellent possibility in the immediate loading concept for mandibular dental rehabilitation.

Torque Test Measurement in Segmental Bone Defects Using Porous Calcium Phosphate Cement Implants

This study was performed to assess the bone healing supporting characteristics of porous calcium phosphate (Ca-P) cement when implanted in a rabbit segmental defect model as well as to determine the reliability of torque testing as a method to verify bone healing. The middiaphyseal radius was chosen as the area to create bilaterally increasing defect sizes (5, 10, and 15 mm), which were either filled with porous Ca-P cement or left open as a control. After 12 weeks of implantation, torque test measurements as well as histological and radiographic evaluation were performed. In two of the open 15 mm control defects, bone bridging was visible at the radiographic and histological evaluation. Bone was observed to be present in all porous Ca-P cement implants (5, 10, and 15 mm defects) after 12 weeks. No significant differences in torque measurements were observed between the 5 and 10 mm filled and open control defects using a t-test. In addition, the mechanical strength of all operated specimens was similar compared with nonoperated bone samples. The torsion data for the 15 mm open defect appeared to be lower compared with the filled 15 mm defect, but no significant difference could be proven. Within the limitation of the study design, porous Ca-P cement implants demonstrated osteoconductive properties and confirmed to be a suitable scaffold material in a weight-bearing situation. Further, the used torque testing method was found to be unreliable for testing the mechanical properties of the healed bone defect.

Histomorphological, histomorphometrical and biomechanical analysis of ceramic bone substitutes in a weight-bearing animal model.

It was the purpose of this investigation to prove the biomechanical properties, the osteoconductive capacity and the degradation rate of alpha tricalcium phosphate (alpha TCP), a neutralized glass ceramics (GB9N) and a composite material (GB9N+copolymers). In a weight-bearing animal model six substitutes each were implanted in the medial tibial head of the right lower leg of adult Merino-sheep in a standardized surgical technique. After nine months the implants were harvested and prepared for histomorphological and histomorphometrical investigations (undecalcified Masson Goldner staining). For additional biomechanical testing of the specimens, non-operated bone blocks from the contralateral tibia as well as native implants served as controls. No significant differences for the maximum fracture load as well as for the yield strength were detected between harvested specimens and bone blocks from the contralateral tibia. However there were marked differences to ceramics that were not implanted. All substitutes showed osteoconduction, leading to a continuous ingrowth of new formed bone. However in the composite material soft tissue could be identified within the scaffold and there were signs of ongoing bone remodeling, nine months after implantation. The bone per tissue volume of alpha-TCP in conjunction to new bone (=percentage of trabecular bone volume plus percentage of residual substitute) was higher than for GB9N and the composite material. Nine months after implantation the percentage of residual alpha-TCP was 48%, it was 32% for GB9N and 28% for the composite. The intention of further studies should be to accelerate the degradation rates of substitutes and to improve biomechanical properties of implants by either modifying the chemical composition or combining materials with agents as, e.g. growth factors.

Population dynamics of clonogenic stromal precursor cells in hemopoietic and lymphoid organs during bone marrow regeneration

This paper describes our study on the regeneration of hemopoietic and stromal components of bone marrow after mechanically emptying the medullar cavity of the guinea pig tibia. The intensity of hemopoiesis was determined from the number of hemopoietic cells, while the concentration and total number of stromal precursor cells were used to estimate the ability of the bone marrow to produce stromal structures, including its ability to restore a specific microenvironment. We found that there was no direct correlation between the recovery characteristics of hemopoietic and stromal cells. An increase in the population size of stromal precursor cells takes place early after curettage, and stromal fibroblasts become phosphatase-positive according to Gomori, which is characteristic of osteogenic tissue. We have also demonstrated that curettage of 3-5 tubular bones results in the growth of this cell population in the bone marrow of nonoperated bones and even in the spleen, which in guinea pigs participates only in lymphopoiesis.