Osteoplastic Material Research Articles

CLINICAL EFFECTIVENESS AND FEATURES OF THE POSTOPERATIVE PERIOD IN PATIENTS AFTER OSTEOSYNTHESIS OF THE MANDIBLE USING CELL TECHNOLOGIES

Due to a signifi cant increase in the frequency and complexity of maxillofacial injuries, one of the priorities in the development of modern surgical dentistry is the search for new eff ective methods of treating facial bone fractures. In recent decades, the attention of clinicians has been focused on biological treatment methods aimed at restoring bone defects using cell technologies and biological transplants.The aim of the study was to determine the eff ect of using osteoplastic materials based on multipotent adipose- derived mesenchymal stromal cells in dental patients in the surgical treatment of mandibular fractures.Materials and methods. The clinical material included 56 patients, 13 of whom underwent mandibular osteosynthesis with hydroxyapatite bone graft substitute (subgroup 1I), 25 of whom underwent surgery with a combination of multipotent adipose tissue mesenchymal stromal cells, hydroxyapatite bone graft substitute and platelet-rich plasma (subgroup 1B), and 18 of whom underwent spontaneous healing of the fracture line (subgroup 1C). Patients were clinically evaluated on a daily basis. Clinical parameters were assessed on days 1, 3, 5, 7, 10, 14 and 28 after surgery. The postoperative pain syndrome was assessed using the Numerical Rating Scale (NRS), considering the subjective signs of pain in the operated patients.The statistical processing of the study results was performed using the statistical analysis software for biomedical research ‘Microsoft Excel 21’ and ‘Statistica’ (licence number STA862D175437Q). In the statistical processing of the results, we used the variational analysis of series – calculation of the arithmetic mean and its standard error (Mim) – and assessed the signifi cance of diff erences in the results obtained in the comparison groups using the Student’s t-test method. p<0.05 was considered a signifi cant diff erence. [17]. The study was conducted in accordance with the basic provisions of the «Rules of Ethical Principles for Scientifi c Medical Research Involving Human Subjects» approved by the Declaration of Helsinki (1964-2013), ICH GCP (1996), EEC Directive 609 (24.11.1986), Orders of the Ministry of Health of Ukraine ¹ 690 of 23.09.2009, ¹ 944 of 14.12.2009, ¹ 616 of 03.08.2012. The Commission on Biomedical Ethics of the Bukovinian State Medical University found no violations of ethical and moral standards in the conduct of the research (ProtocolNo. 6, 16.03.2023). Patients signed informed consent to participate in this study and all measures were taken to ensure their anonymity.The results. The comparative analysis of the clinical eff ectiveness of the use of various osteoplastic materials in the performance of osteosynthesis surgery of the lower law confi rmed the advantages of the use of bone tissue substitute based on hydroxyapatite and its combination with multipotent adipose tissue mesenchymal stromal cells before spontaneous augmentation. It is confi rmed by the data of subjective and objective symptoms of patients during the postoperative period.Conclusions. Our data show that osteoplastic material based on multipotent mesenchymal stromal cells of adipose tissue, bone substitute based on hydroxyapatite and platelet-rich blood plasma is a promising biological material. Its application improves the regenerative and reparative properties of bone tissue, facilitates the postoperative period and shortens the duration of hospitalization, promotes the development of innovative ways of reconstructive osteogenesis in modern maxillofacial surgery.

BIOMECHANICAL ASPECTS OF IMPACTION BONE GRAFTING IN THE ACETABULAR REVISION (EXPERIMENTAL AND CLINICAL WORK)

Introduction. The modern features of the revision hip arthroplasty are the increase of the number early revisions and young age of patients. Bone defect management in this category is especially relevant. The leading role in long-term survival using impaction bone grafting (IBG) is given to the mechanical properties of the graft. The purpose of the study is to explore the mechanical properties of osteoplastic material and determine the effect of cyclic loads on dynamic changes in the position of the acetabular component after revision hip arthroplasty using (IBG). Materials and methods. A single-cycle constrained compression experiment was carried out on morselized xenobone. Cyclic tests were carried out at the second stage of the study. Clinical interpretation of biomechanics was carried out on the radiographic data by changes in the acetabular position. Results. Stress-strain dependences and instantaneous elastic moduli were obtained. The increase of the instantaneous elastic modulus during cyclic tests was obtained by 2.6 times for a “dry” specimen and from 3.9 to 4.7 times with liquid. The shift of the center rotation cranially and laterally was noted in the first case is 2.4 and 1.5 mm, in the second is 14.9 and 9.5 mm, respectively. The change in the inclination was 18.7º in the first case and 19.8º in the second. The Hip Harris Score (HHS) was 97 points in the first case, 53 points in the second. Conclusions: 1. The material used for IBG is subject to deformation in the postoperative period. 2. Compression tests suggested that the deformation of impacted bone graft in the postoperative period gradually tends to reach a plateau, and with the completion of the deformation, migration of the acetabular component stops. 3. A change of the acetabular component position in the absence of a radiolucent line is not an absolute sign of loosening.

Evaluation of the radiographic picture in the area of a bone defect filled with osteoplastic material based on hydroxyapatite

Reparative regeneration of bone tissue occurs by activating complex biological processes. In some cases, there is a need to stimulate these processes using biomaterials. One of the suitable biomaterials that has a stimulating effect on osteogenesis is hydroxypatite doped with silicate ions (silicate-substituted hydroxyapatite). Analogues of this biomaterial are used to replace bone tissue in clinical practice and show relatively high efficiency of use, which makes it possible to improve the structure by introducing various components into it. Thus, the osteoplastic material we proposed is being studied for the efficiency of use and evaluation of stimulation of reparative regeneration. Preclinical study was conducted on the basis of the Institute of Biomedical and Biological Sciences of the Omsk State Agrarian University named after P.A. Stolypin. In vivo studies were conducted using granules of silicate-substituted hydroxyapatite in a ratio of 50/50 to wollastonite with a diameter of 0.5 mm. The objects of the study were laboratory rabbits with models of bone defects performed in the form of an induced fracture of the proximal third of the tibia diaphysis with subsequent fixation by transosseous introduction of pins. Groups of animals were formed: experimental with the introduction of silicate-substituted hydroxyapatite granules into the defect cavity and control without defect replenishment. To assess the course of reparative regeneration and osteogenesis, an X-ray examination was performed on the 7th and 21st days, and an assessment of the clinical condition of the animals was carried out for 30 days. According to the X-ray images obtained on the 7th day, the following changes were revealed: the experimental group of animals showed signs of new bone tissue formation, as well as full contact of the defect cavity with the studied osteoplastic material, while in animals from the control group, clearly defined edges of the defect zone are visualized without signs of bone regenerate formation. Repeated X-ray examination on the 21st day showed pronounced signs of bone callus formation in the experimental group, while in the control group the regeneration process was slower, the formation of bone regenerate was less pronounced, and initial signs of fibrocartilaginous bone callus formation were noted. The data obtained during the study suggest that silicate-substituted hydroxyapatite has a stimulating effect on reparative regeneration and requires further study.

Comparative Effectiveness of an Autologous Dentin Matrix for Alveolar Ridge Preservation.

An urgent issue is the preservation or reconstruction of the volume of bone tissue in planning and surgical treatment in the fields of medicine, such as traumatology, orthopedics, maxillofacial surgery and dentistry. After tooth extraction, resorption of the bone tissue of the alveolar crest of the jaws occurs, which must either be further eliminated by performing additional operations or using osteoplastic material for socket preservation at the extraction stage. Background and Objectives: The aim of the study was a comparative analysis of various osteoplastic materials used to preserve the volume of bone tissue in the preimplantation period. Materials and Methods: As part of the study, 80 patients were treated, who underwent socket preservation using xenografts, plasma enriched with growth factors, an autologous dentin matrix (ADM) and hydroxyapatite. Results: The results of the treatment 16 weeks after removal were comprehensively analyzed using a morphometric analysis of the bone's volume, cone beam tomography and morphological examination of burr biopsy specimens, as well as by determining the stability of the installed implant at different stages of treatment. Conclusions: The lowest level of bone tissue resorption according to the CBCT data was noted in the ADM and xenograft groups. It should be noted that the use of osteoplastic material in jaw surgery when reconstructing alveolar defects is an essential procedure for preventing the atrophy of bone tissue.

IMPROVEMENT OF REPARATIVE REGENERATION OF THE JAW BONE IN EXPERIMENT

We conducted an experimental study on the effectiveness of the combined use of osteoplastic material Collapan-L with adhered MSCs to improve the processes of jaw bone regeneration in rats. The animals were divided into two groups: experimental and control groups of 50 animals each. Bone damage was induced in rats by drilling a defect with a dental bur in the area of attachment of the masticatory muscles in the angle of the mandible. We used only Collapan-L in the control group, and Collapan-L with adherent MSCs in the experimental group. During the cultivation process, statistically significant changes in concentration, depending on the day of cultivation, were observed for all cytokines: IL-1β (p<0.001 ANOVA), IL-2 (p=0.007 ANOVA), IL-4 (p=0.02 ANOVA), IL-6 (p=0.003 ANOVA), IL-8 (p=0.003 by Kruskal-Wallis test) and TNF-α (p<0.001 ANOVA). The dynamics of changes in the cytokines had a wave-like character. By the day 30 of the experiment, in animals with injected Collapan-L, the total volume of bone tissue in the regeneration zone was 50.14%, and in the Collapan-L + MSCs group it was 75.4%. The use of osteoplastic material Collapan-L with adhered MSCs is an effective combination for improving regeneration processes and reducing the inflammatory response of bone tissue.

In vivo evaluation of bioactivity of alginate/chitosan based osteoplastic nanocomposites loaded with inorganic nanoparticles

The influence of two nanostructured osteoplastic materials with different compositions: i) alginate (Alg) matrix, loaded with Zn2+ ions and nanostructured hydroxyapatite (HA) - S1/HA-Zn, and ii) chitosan (CS) matrix loaded with brushite nanoparticles (NPs, dicalcium phosphate dihydrate, DCPD) - S2/DCPD on the healing of an experimental femoral diaphysis defect was investigated. The structure of cellular elements and the lacunar tubular system of the regenerated bone tissue were studied by electron microscopy. Osteogenic cells on the surface and inside S1/HA-Zn formed bone tissue. On the 30th day, the latter had a reticulofibrous and later lamellar structure. On the 30th day, the S2/DCPD biomaterial was integrated mainly into connective tissue and, starting from the 90th day, into the bone tissue, which was formed only on its outer surface. Thus, it has been proven that both biomaterials contribute to the healing of bone wounds. The regenerative potential of the new bone tissue formation of S1/HA-Zn prevails over that of S2/DCPD.

Results of biochemical and histological studies after restoration of bone defects using cellular technologies in dental patients

Objective of the research was to find out the effectiveness of the use of osteoplastic materials based on the multipotent mesenchymal stromal cells of the adipose tissue during surgical treatment for restoration of bone defects in dental patients. The clinical material included examination of 79 patients who underwent replacement of bone defects of the alveolar processes and/or an alveolar part of the appropriate jaw by means of different osteoplastic materials and their combinations or without their application (the control group). Acid phosphatase activity in the oral fluid of patients was determined by means of the unified “end point” method. Alkaline phosphatase activity in the oral fluid was determined using a set of reagents produced by the company “Filisit-Diagnostika” (Ukraine). Oral fluid mineralization index (MI) of patients was calculated according to the ratio of enzymatic activity of alkaline phosphatase (ALP) to acid phosphatase (AP) according to the formula: MI=ALP/AP. Histological material was taken at the stage of installation of a dental implant. It was established that the use of a composition based on multipotent mesenchymal stromal cells of adipose tissue, platelet-enriched blood plasma and bone tissue substitute containing hydroxyapatite contributes to the improvement of regenerative processes in the bone tissue of the jaws, which is confirmed by a 28.68% decrease in acid phosphatase activity, an increase by 25, 97% of alkaline phosphatase activity in the oral fluid of group B patients and, accordingly, a 77.08% increase in the ratio of alkaline to acid phosphatase. According to the results of histological studies and phase-contrast microscopy, after 6-8 months of observation, in patients of group B, the areas of jaw defects were filled with newly formed bone tissue, identical to native bone, and the resulting trepanobioptas had the structure of cancellous bone with osteoblastic elements forming a chain around osteoid tissue. Having analyzed the results of biochemical and histological studies it was established that application of an osteoplastic composition based on the multipotent mesenchymal stromal cells of the adipose tissue, bone tissue substitute with hydroxyapatite and platelet-rich plasma allows restoration of bone defects of the alveolar processes and an alveolar part of the appropriate jaw in shorter terms. The method is an optimal alternative to traditional osteoplastic materials to be used in modern dental practice and dental implantation.

Promising osteoplastic materials and surgical technologies in reconstructive treatment of patients with bone nonunion and defects

Introduction Some progress has been made in the development of innovative implantation materials for osteoplastic surgery. However, the problem of bone defect management still remains relevant due to the continued high prevalence of injuries resulting from road accidents, catatrauma, man-made disasters and military operations.The purpose of the work was to analyze the relevant literature and to identify options for solving the problems of bone nonunion and defect management using materials developed on the principles of orthobiology and surgical technologies based on autologous repair.Materials and methods The search for sources was carried out with the ConnectedPapers analytical tool and the capabilities of the eLibrary electronic library using keywords and without restrictions on publication date.Results and discussion Recent publications contain information about the effectiveness of the combination of Masquelet technology and Ilizarov bone transport in patients with acquired and congenital defects, including in the conditions of active purulent infection. According to the literature, a promising autologous bone plastic material is the contents of the bone marrow cavity, containing osteogenic growth factors and bone morphogenetic proteins. Biomaterial is collected using the Reamer-Irrigator-Aspirator system (RIA) from the intramedullary canal of the femur or tibia. Currently, the effectiveness of bone morphogenetic proteins rhBMP-2 and rhBMP-7 in the restorative treatment of patients with bone defects and nonunion of various etiologies has actually been proven. The use of bone morphogenetic proteins has been introduced into foreign treatment protocols. Recent positive results of a combination of surgical technologies have proposed the combined use of the Ilizarov and Masquelet technologies, supplemented by PRP therapy. The basis for the expected effect from the combination of surgical technologies and orthobiological materials are the results of preclinical studies of the osteogenic potential of PRP therapy.Conclusion There are grounds for studying the clinical effect of the combined use of surgical technologies based on autologous reparative processes and materials developed on the principles of orthobiology. It is necessary and advisable to clinically implement the use of bone morphogenetic proteins rhBMP-2 and rhBMP-7 in the reconstructive treatment of patients with bone defects and nonunion of various etiologies. Multicenter clinical studies of a high level of evidence are needed to determine the effectiveness of PRP therapy in the reconstructive treatment of patients with bone nonunion and defects.

Efficacy of the use of a therapeutic composition containing stem cells in the augmentation of the alveolar ridge according to the indicators of bone remodeling markers in the saliva

Maxillofacial bone defects may result from various pathological conditions, such as traumatic tooth extraction, aggressive periodontitis, jaw osteomyelitis, neoplasms, cysts, congenital malformations, and gunshot injuries. These circumstances can pose difficulties in addressing both (primary and secondary) dental adentia, especially when considering dental implantation. One of the current challenges in dentistry is to give more attention to the advancement of innovative osteoplastic materials. The purpose of this study was to assess the effectiveness of a therapeutic composition that includes stem cells in enhancing the alveolar ridge, as suggested by bone remodeling markers in oral fluid. The research revealed that all study groups showed favorable changes in oral fluid markers of bone metabolism during the extended follow-up period (6-12 months), with statistically significant differences (p2<0.01, 0.05). However, in group A, acid phosphatase activity decreased by 12.98% (p>0.05) and 32.49% (p<0.01, p1<0.05), while alkaline phosphatase increased by 8.73% (p>0.05) and 15.16% (p>0.05), respectively, after one year of observation compared to groups B and C. Thus, it can be inferred that a reduction in acid phosphatase activity, along with a rise in alkaline phosphatase levels in oral fluid, suggests enhanced regenerative processes and the initiation of bone remodeling in the patients belonging to the study group. However, it seems that the procedures were particularly effective in patients belonging to group A, where we used the combination of “Bio-Oss”+MSCs-AT+PRP to fill bone defects. This suggests the best effectiveness of the composition we developed for alveolar ridge augmentation.

Results of bone grafting using a xenogenic cortical plate BiOTECK

BACKGROUND: The fundamental condition that determines the effectiveness of treatment, with immediate and long-term positive results, is the amount of bone tissue in the jaws at the proposed implantation site. Defects in the dentition to a large extent and severe atrophy of the bone tissue of the jaws due to the loss of teeth significantly limit the use of dental implantation. It is reasonable to expand the indications for the use of dental implants in cases of atrophy of the jaw bone tissue in the installation site. This allows the optimization of surgical techniques aimed at increasing the volume of the jaw bone tissue, such as the use of new osteoplastic materials for guided bone regeneration.
 AIM: This study aimed to analyze the results of a jawbone graft using a BiOTECK xenogeneic cortical plate.
 MATERIALS AND METHODS: The test group consisted of 22 patients (11 men and 11 women) with jawbone atrophy. All patients underwent bone graft surgery using a BiOTECK xenogeneic cortical plate (BiOTECK, Italy).
 In the course of the study, all patients with jawbone loss underwent a dynamic clinical and X-ray examination during the following stages: during the dental implant surgery planning stage aimed at determining the volume of the bone tissue available and identifying the associated conditions and diseases (prior to conducting an osteoplastic procedure), prior to dental implant installation (6 months after osteoplastic surgery), and prior to the start of the orthopedic stage of treatment (12 months after osteoplastic surgery).
 RESULTS: The cone beam computed tomography data were analyzed and statistically processed to obtain the results. It was revealed that the values of the “bone densitometry” indicator increased 6 months after the bone graft using the BiOTECK xenogeneic cortical plate, and the values of the “densitometric density of jaw bone tissue” indicator increased.
 Immediately after bone grafting using the BiOTECK xenogeneic cortical plate, the thickness of the bone tissue of the upper jaw increased by an average of 5.0±0.1 mm and that of the lower jaw increased by an average of 3.9±0.1 mm. In the first stage of the dental implant surgery (6 months after osteoplastic procedure), due to resorption, the thickness of the bone tissue of the alveolar process of the upper jaw decreased by 1.1±0.1 mm and amounted to 6.8±0.1 mm (bone resorption rate: 13.9%), and the thickness of the bone tissue of the alveolar process of the lower jaw decreased by 0.8±0.2 mm and amounted to 6.6±0.3 mm (bone resorption rate: 10.3%).
 CONCLUSION: The clinical and X-ray results obtained 1 year after installing dental implants and performing bone graft surgery using the BiOTECK xenogeneic cortical plate indicate a stable volume of marginal bone tissue in the area of alveolar crest reconstruction.

The efficacy of using the allogeneic osteoplastic material in skull trepanation

Introduction. When performing osteoplastic craniotomy, there is a need to fill the diastasis between the skull bone and the explanted bone fragment. Grafts based on allogeneic bone chips and collagen (bone-plastic material) may be very effective for cranial bone repair in diastasis area.Aim. To evaluate the safety and clinical efficacy of osteoplastic material during the osteoplastic craniotomy.Material and methods. A retrospective and prospective clinical study was conducted at the N.V. Sklifosovsky Research Institute for Emergency Medicine and included 12 patients treated in Urgent Neurosurgery Department with diagnoses suggesting the need for craniotomy. Allogenic osteoplastic material was obtained from a 0.7-0.9% solution of type I collagen and spongy bone chips with a fraction size of 315-630 microns. Osteoplastic material grafts were used intraoperatively at the cranioplastic stage of the operation after the main stages had been completed. The efficacy and safety of the use of osteoplastic material were evaluated clinically and radiologically in the early postoperative period.Results. In the early postoperative period, the study patients had no pyo-septic complications, severe pain or soft tissue swelling. All patients were discharged from the hospital in satisfactory condition to be followed-up by the physician or neurologist at the out-patient facility. The computed tomography performed in the early postoperative period visualized the diastasis lines along the bone flap line in the comparison group patients (without osteoplastic material); and in the main group, the osteoplastic material was clearly visualized. At computed tomography of the skull performed after 6–9 months and after 2–18 months, the signs of bone tissue consolidation were visualized in the patients of the main group. The radiodensity of the autologous bone flap in both groups did not significantly change at any periods. In the diastasis area, the radiodensity of diastasis in the main group was significantly higher than in the comparison group. After 1-1.15 years the radiodensity values in the diastasis area increased by average of 1.95 times (p<0.05) in the patients of the main group, while in the patients without osteoplastic material, this parameter did not significantly change during the entire follow-up period.Conclusions. In patients with intraoperative cranioplasty osteoplastic material grafts did not cause complications in the early and late postoperative period. Intraoperative cranioplasty performed with using osteoplastic allogeneic material caused no complications in either early or late postoperative periods. The presence of osteoplastic material contributed to the consolidation of the autologous bone flap and healthy bone.

Composite Remineralization of Bone-Collagen Matrices by Low-Temperature Ceramics and Serum Albumin: A New Approach to the Creation of Highly Effective Osteoplastic Materials.

This study examined the effectiveness of coating demineralized bone matrix (DBM) with amorphous calcium phosphate (DBM + CaP), as well as a composite of DBM, calcium phosphate, and serum albumin (DBM + CaP + BSA). The intact structure of DBM promotes the transformation of amorphous calcium phosphate (CaP) into dicalcium phosphate dihydrate (DCPD) with a characteristic plate shape and particle size of 5-35 µm. The inclusion of BSA in the coating resulted in a better and more uniform distribution of CaP on the surface of DBM trabeculae. MG63 cells showed that both the obtained forms of CaP and its complex with BSA did not exhibit cytotoxicity up to a concentration of 10 mg/mL in vitro. Ectopic (subcutaneous) implantation in rats revealed pronounced biocompatibility, as well as strong osteoconductive, osteoinductive, and osteogenic effects for both DBM + CaP and DBM + CaP + BSA, but more pronounced effects for DBM + CaP + BSA. In addition, for the DBM + CaP + BSA samples, there was a pronounced full physiological intrafibrillar biomineralization and proangiogenic effect with the formation of bone-morrow-like niches, accompanied by pronounced processes of intramedullary hematopoiesis, indicating a powerful osteogenic effect of this composite.

Functionalization of Osteoplastic Material with Human Placental Growth Factor and Assessment of Biocompatibility of the Resulting Material In Vitro.

This article provides the results of a study of the interaction of placental growth factor with adipose-derived stem cells (ASCs) of various origins, as well as the possibility of generating osteoplastic material based on xenogeneic matrix functionalization with human placental growth factor (PLGF). It is demonstrated that the greatest release of this factor from the functionalized material into the medium occurs during the first 3 h of contact with the model medium, but then the levels of the factor being released fall sharply, although release did continue throughout the 7 days of observation. The modified material was not cytotoxic, and its surface provided good cell adhesion. During 3 days of cultivation, the ASCs proliferated and migrated more actively on the surfaces of the modified material than on the surfaces of the control material. This study can serve as the basis for the development of original methods to functionalize such osteoplastic material by increasing PLGF immobilization by creating stronger bonds in order to regulate both factor dosage and the dynamics of the factor release into the environment. Further studies in experimental animals should facilitate assessment of the effectiveness of the functionalized materials. Such studies will be useful in the development of osteoplastic materials with new properties resulting from the inclusion of growth factors and in research on their biological activity.

Кістково-пластичні матеріали та способи їх використання (огляд)

Relevance. In case of bone deficiency or defect in the area of subsequent implantation, it is rational to perform bone grafting. There are various techniques for bone grafting operations that differ in incisions, volumes, materials, and methods of their use during surgery. When using bone grafting materials, different substrates are used for their mixing. The purpose of the work is to provide a structured understanding of the current state of development of bone grafting on the example of studies related to operations using bone grafting materials and substances for their mixing (substrates); to identify areas that have not been paid attention to. Conclusions: 1. Currently, the issue of choosing a substrate for kneading osteoplastic materials has not been sufficiently studied. 2. There is a need to conduct a study comparing different substrates for kneading bone tissue. 3. It is necessary to create scientifically based guidance on the use of different substrates for different clinical cases. Key words: bone grafting, bone grafting materials, implantation.

Изучение эффективности использования комбинированных остеопластических материалов при реконструктивных вмешательствах в полости рта

Изучение эффективности использования комбинированных остеопластических материалов при реконструктивных вмешательствах в полости рта

Modern osteoplastic materials

Relevance. Bone tissue regeneration and the development of methods for directed influence on the processes of bone healing are of the most urgent problems of modern medicine. Defects in the jaw bones are widespread, which in turn leads to the search for modern bone - replacing materials that meet the basic characteristics of the bone. Information was searched based on the PubMed and E-library databases, using the keywords: “bone tissue” AND “bone regeneration” AND “osteoplastic materials” AND “osteoinduction” AND “osteoconduction”. Autologous bone is considered the clinical gold standard and the most effective method of bone regeneration. It is the autograft that has three main characteristics: osteogenicity, osteoinductive and osteoconductive. The autograft has limitations due to the limited amount of bone tissue and the soreness of the donor site. A viable alternative to autologous bone is an allograft. The most widely used allograft is demineralized freeze - dried bone allograft (FDBA). The freeze - drying process promotes damage to osteoblasts, which limits its osteoinductive potential, but it is a profitable alternative in terms of convenience, abundance of choice and absence of pain due to the absence of additional surgical intervention. The main component of xenogeneic materials is collagen, which has the ability to resorb in tissues and stimulate regenerative processes. The material has osteoconductive properties and is capable of bone ingrowth, with the formation of a new bone directly from the xenomaterial bed with the deposition of bone cells on its surface. Subsequently, the xenomaterial undergoes resorption with complete replacement with new bone tissue. Alloplastic materials are fully synthetic materials synthesized from inorganic sources. Alloplastic materials have the property of osteoconduction, and when various growth factors are added to their composition, the property of osteoinduction is added to osteoconductive. The clinical use of bone substitutes is limited by their fragility as well as their unpredictable rate of resorption, which render these materials generally less favorable in clinical outcomes. Conclusion. Until now, a scientific search for various materials capable of replacing an autogenous transplant is being carried out. At the moment, none of the currently available materials has all the desired characteristics and the choice of materials directly depends on the specific clinical situation in the oral cavity.

Restoration of X-ray bone density when replacing cortical plate defects with a tissue-engineered construct in the experiment

Over the past decade, in global practice, the frequency of using high-resolution multi-layer spiral computed tomography (MSCT) for assessing the state of cancellous and cortical bone tissue has significantly increased. Using high-resolution MSCT makes it possible to assess X-ray bone density at various times after replacement of cortical plate defects with osteoplastic materials. The aim of the research. To study the restoration of cortical bone density in the area of osteoplasty using tissue-engineered construct in the experiment. Materials and methods. In an in vivo experiment on New Zeland White (NZW) rabbits, perforation defects of cortical bone were formed in the femoral diaphysis. Three study groups were set up: group 1 – without bone defect replacement; group 2 – with bone defect replacement with deproteinized cancellous bone; group 3 – with bone defect replacement with tissue-engineered construct based on deproteinized cancellous bone with stromal vascular fraction of adipose tissue. Follow-up periods were 2, 4 and 6 weeks after the surgery. The X-ray density of cortical bone tissue was measured in Hounsfield units (HU). Fragments of deproteinized human cancellous bone were used alone and in combination with the stromal vascular fraction of NZW rabbit adipose tissue as a bone-replacing material for bone defect replacement. Results. Cortical plate density the in the area of the defect in the group 3 by the week 6 is on average 1.3 times lower than that of the intact cortical plate and corresponds to D1 according to Misch classification. Cortical plate density in the area of the defect on the side of medullary canal by the week 6 in the group 3 corresponds to D1 according to Misch classification and is equal to 1351.25 ± 221.18 HU (1052; 1805), which is 1.5 times higher than in group 2 (D2 according to Misch classification; p < 0.05). The obtained results indicate an earlier restoration of X-ray bone density when using a tissue-engineered construct (group 3) compared to the same indicators in groups 1 and 2.

Pre-treatment of granular osteoplastic material for improving the reparative regeneration of jaw bone defects

Aim – to develop a method for preliminary preparation of a granular osteoplastic material (GOM) for improving the quality of reparative osteogenesis of jaw bone defects that can be used in clinical setting.
 Material and methods. The in vitro study was performed using 9 samples (3 samples in each study group). Group 1 included intact samples of grafting material Cerabone (Botiss biomaterials GmbH, Germany). In group 2, the samples of Cerabone (Botiss biomaterials GmbH, Germany) were subject to degassing and dust extraction in two stages using the original method developed by the author. In group 3, a culture of mesenchymal-stromal cells (MSC) obtained from the human umbilical cord was used as a control. The developed method was assessed for cytotoxicity using human MSC. The proliferative index and cell doubling time were registered. A topographic analysis of the sample surface was performed using scanning electron microscopy. To assess the rate of degassing, the experiment included three replicates. The fluid volume was recorded every 2.5 minute. For statistical data processing, we used SPSS 25.0 software (IBM Corporation, Armonk, New York, USA).
 Results. In Group 2, that included the samples of GOM fractions with the preliminary degassing and dust extraction, we revealed a decreased content of coarse and fine fraction dust on the outer and inner surfaces of the pores and mouths of interpore channels and voids in all samples. The granular osteoplastic material prepared for the use by the method of degassing and dust extraction proved to have no toxic effect on the growth and viability of human mesenchymal-stromal cells.
 Conclusion. A preliminary preparation of GOM by the method of degassing and dust extraction developed by the author in clinical conditions ex tempore significantly optimizes the adsorption and drainage properties of the GOM fraction.

Effect of zinc oxide micro- and nanoparticles on cytotoxicity, antimicrobial activity and mechanical properties of apatite-polymer osteoplastic material

This work is devoted to the comparison of the physical and biological properties of synthesized osteoplastic composites with an experimentally determined content (375 μg/g) of the micro (ZnOMPs) and nano (ZnONPs) particles, immobilized in Hydroxyapatite-Alginate-Chitosan matrix (HA-Alg-CS). ZnONPs show pronounced antimicrobial activity against E.coli ATCC 25922 and S. aureus ATCC 25923, while ZnOMPs only in the CS presence. Composites containing ZnONPs/MPs do not have a toxic effect on bone-forming cells - osteoblasts, preserving their ability to biomineralization. ZnOMPs and ZnONPs to varying degrees, but significantly affect composites’ swelling, porosity, shape stability, and prolong vitamin D3 release for 120h, compared to Control. Composites do not demonstrate unwanted “burst release.” ZnONPs/MPs increase Youngs' modulus of the HA-Alg matrix, namely 348 → 419 MPa (ZnOMPs), 348 → 646 MPa (ZnONPs), and weaken the plastic (irreversible) deformations. The compressive strength of HA-Alg and HA-Alg/CS matrixes containing ZnONPs (178 MPa and 251 MPa, respectively) is in the range of values for native cortical bone (170–193 MPa). Biocompatibility and lack of toxic effect give both composites a perspective for osteoplastic application, but composites doped with ZnONPs are more attractive.

РОЛЬ КОЛЛАГЕНА И ГИДРОКСИАПАТИТА В СОСТАВЕ КОМПОЗИЦИОННЫХ КОСТНОПЛАСТИЧЕСКИХ МАТЕРИАЛОВ, ИСПОЛЬЗУЕМЫХ В ЧЕЛЮСТНО-ЛИЦЕВОЙ ХИРУРГИИ (обзор литературы)

Abstract. Introduction. Bone tissue reconstruction is one of the most challenging problems of maxillofacial surgery. This paper provides a review of studies related to the use of hydroxyapatite- and collagen-based osteoplastic materials for jawbone defects. Aim of our study is the review of the latest information on how essential collagen and hydroxyapatite as part of osteoplastic composites used in maxillofacial surgery. Materials and Methods. The published topical studies are reviewed, dealing with the study of collagen and hydroxyapatite as part of osteoplastic composites. Results and Discussion. Collagen implants promote fibroblast proliferation, vascularization of nearby tissues and induce the formation of new bone tissue with its subsequent restructuring. Collagen was also used as a rapidly biodegrading material in form of a gel for the restoration of bone defects. Conclusions. Currently, considering the positive qualities of collagen and hydroxyapatite, we see their widespread use as part of composite bone plastic materials as promising.