Use Of Beta-tricalcium Phosphate Research Articles

Efficacy of pure beta tricalcium phosphate graft in dentoalveolar surgery: a retrospective evaluation based on serial radiographic images

BackgroundThe use of beta-tricalcium phosphate (beta-TCP) in dental surgery is limited owing to its rapid absorption compared to mixed formulations of hydroxyapatite. However, newly developed pure beta-TCP crystals have demonstrated slow absorption; hence, they last longer within the defect and act as a scaffold until new bone formation. The oral environment is unique and can prove unfavorable for bone grafts due to the high infection rate in the oral cavity and the fragile condition of the oral mucosa. The aim of this study was to evaluate the feasibility of using pure beta-TCP bone grafts in various dental treatments.MethodsPanoramic X-ray images of 25 patients who underwent bone grafting during dental surgery were analyzed. A specially treated pure beta-TCP crystal, Neo Bone® (Neo Bone®, SN Biologics Co., Ltd, Seoul, Korea), was used in this study. The bone density at the graft site was compared with that of the surrounding bone using the ImageJ software (Wayne Rasband, NIH USA).ResultsSix months after surgery, the bone graft density was similar to that of the surrounding bone in 20 patients and increased in 5 patients. No adverse effects, such as infection, dehiscence, or graft failure, were observed.ConclusionThe newly developed pure beta-TCP crystal was slowly absorbed and served as support until new bone formation at the defect site, thus demonstrating its potential for use in various oral conditions requiring bone grafting.

Combined use of beta-tricalcium phosphate with different porosities can accelerate bone remodelling in open-wedge high tibial osteotomy

Background/ObjectiveBeta-tricalcium phosphate (β-TCP) is often used as a gap filler in open-wedge high tibial osteotomy (OWHTO). The aim of the present study was to investigate the effects of using β-TCP with different porosities on bone remodelling after OWHTO.Methods: We evaluated 29 knees in 26 patients that underwent OWHTO using β-TCP with porosities of 60% and 75% (combined group). A further 30 knees in 28 patients that underwent OWHTO using β-TCP with 60% porosity alone were allocated as a control group. In the combined group, a β-TCP block with 75% porosity was inserted into the gap at the cancellous bone site and a β-TCP block with 60% porosity was inserted into the medial cortical bone side. In the control group, a β-TCP block with 60% porosity was inserted into the osteotomy gap. The bone remodelling phases of the inserted β-TCP blocks were evaluated on standard anteroposterior radiographs using the modified van Hemert classification at 3 and 6 months post-operatively. ResultsThe rate of satisfactory bone remodelling at the cancellous bone sites was 86.2% (25/29) in the combined group and 0% (0/30) in the control group at 3 months post-operatively (p<0.05), progressing to 96.6% (28/29) in the combined group and 20% (6/30) in the control group at 6 months post-operatively (p<0.05). ConclusionThe present study demonstrated that combined use of β-TCP with high and low porosities can significantly enhance bone formation. The combined use of artificial bones with different porosities is useful for early bone remodelling in OWHTO.

Effectiveness of beta-tricalcium phosphate in comparison with other materials in treating periodontal infra-bony defects around natural teeth: a systematic review and meta-analysis

BackgroundBeta-tricalcium phosphate in regenerative surgery has shown promising results in terms of bone gain and new vital bone formation; however, several studies have contradicted this finding. The aim of this study was to evaluate the effectiveness of beta-tricalcium phosphate compared to other grafting materials in the regeneration of periodontal infra-bony defects.MethodsElectronic database (Cochrane, MEDLINE, PubMed, Embase, Science Citation Index Expanded) and manual searches for related data were performed up until March 2020. The outcomes were pocket depth reduction, clinical attachment level gain, and amount of bone fill.ResultsFive studies were selected based on the inclusion criteria. Bone regeneration with beta-tricalcium phosphate was observed to be superior to that with debridement alone but showed comparable results to other bone graft materials in terms of pocket depth reduction, clinical attachment level gain, and bone fill. Regenerative procedures for periodontal infra-bony defects that used beta-tricalcium phosphate in combination with other growth factors yielded superior outcomes. The meta-analysis revealed that for cases with two-wall defects, the use of beta-tricalcium phosphate yielded statistically significant differences in pocket depth reduction and clinical attachment level gain, but not in bone fill.ConclusionsBeta-tricalcium phosphate appears to be a promising material for use in periodontal infra-bony defect regeneration around natural teeth. However, randomized clinical trials with larger sample sizes and more controlled study designs are needed to support these findings.

Use of Beta-tricalcium Phosphate Bone Graft with Collagen Membrane as Guided Bone Regeneration in Long Bone Fractures with Bone Loss in Dogs: A Clinical Study

Background: Fractures associated with bone loss requires stabilization with suitable fixation devices, placement of appropriate bone grafts to fill up the bone defects and barrier membranes as space maintainers for enhanced bone regeneration. The aim of this study was to evaluate the use of beta-tricalcium phosphate (β-TCP) bone graft with collagen membrane as guided bone regeneration in long bone fractures with bone loss in dogs. Method: Six dogs with long bone fractures accompanied with bone loss in Radius-ulna, Femur and Tibia were surgically treated with suitable bone plate as internal fixation with β-TCP bone graft along with collagen membrane placed at the fracture site. Conclusion: The application of β-TCP along with collagen membrane for filling the bone defect is extremely simple, convenient and less time consuming and proved to be effective in promoting early bone healing with rapid later phase bone healing and provided osteoconductive support and early resorption.

Role of Beta Tri-calcium Phosphate-based Composite Ceramic as Bone-Graft Expander in Masquelet's-Induced Membrane Technique.

Background:Filling bone defect after debridement of infected nonunion is an orthopedic challenge. Since the volume of autologous bone graft available is limited, allograft, demineralized bone matrix, and calcium phosphate ceramic-based bone graft substitutes have come up as potential autograft expanders. This study was conducted to analyze the use of beta tri-calcium phosphate (B-TCP)-based composite ceramic as autologous bone-graft expander in the management of postinfective segmental gap nonunion of long bones managed with two-stage Masquelet's technique.Materials and Methods:42 consecutive patients with postinfective segmental long bone defects of 4–12 cm managed with Masquelet's-induced membrane technique, operated between February 2012 and June 2015, were included in this prospective case series. During the second stage bone-grafting procedure, iliac crest autograft alone or mixed with B-TCP granules (ratio not exceeding >1:1) was used along with appropriate internal-fixation. Bony union (defined clinicoradiologically as ability to painlessly bear weight on affected limb without support along with bridging of 3 cortices on X-rays) was evaluated.Results:Union was achieved in 80.9% patients (34/42) with index bone grafting. 100% union rate was achieved in patients where only autograft was used (15/15) and in nonsmoker femoral nonunion patients with the use of B-TCP (13/13). The use of B-TCP was associated with higher rate of nonunion in smokers (6/8, 75%) and in tibial nonunions (4/9, 55.5%). All, but one, of 8 patients with nonunion, united after the second-bone grafting procedure.Conclusion:B-TCP is an efficacious and safe autologous bone graft expander in Masquelet's two-stage management of post infective segmental gap nonunion of long bones. Patients should be counseled regarding increased risk of nonunion and need for repeat grafting with its use, especially if they are smokers or site of involvement is tibia.

Evaluation of Bone Repair in the Mandible of Rabbits Using Biphasic Calcium Phosphate Micro-Macroporous Hydroxyapatite Bioceramics and Beta-Tricalcium Phosphate

Objective: To perform a clinical and histological evaluation, characterizing and proving the feasibility of the use of beta tricalcium phosphate (HA/βTCP) bioceramics as a bone defect repair material, comparing it with autogenous bone and blood clot in terms of osteoinductive, conductive, and genic capacities. Material and Methods: The experiment was based on 3 critical defects in the mandible of 11 New Zealand rabbits. The defects were filled with HA/βTCP bioceramics and autogenous bone, respectively, collected and ground during the development of defects and blood clots. The animals were euthanized after the 90-day experiment and samples were collected for histomorphological examination. To evaluate differences between the groups, a one-way analysis of variance (ANOVA) was performed with Tukey’s post hoc test. An αvalue lower than 0.05 was considered statistically significant. Results: Microscopy revealed the presence of osteoblasts, osteoclasts, and osteocytes associated or not associated with the presence of mature or immature bone. All the studied materials presented bone neoformation in all cases, with the presence of mature and immature bone. Regarding the presence of HA/βTCP bioceramic residual material, the same was found in 7 of 11 slides. Conclusion: HA/βTCP bioceramics were shown to be a biocompatible bone substitute, with osteoinductive and osteoconductive characteristics, accelerating the process of new bone formation when compared with autogenous and blood clotted bone, thereby showing promise for bone defect repair with safety and efficacy.

Use of autogenous bone and beta-tricalcium phosphate in maxillary sinus lifting: histomorphometric study and immunohistochemical assessment of RUNX2 and VEGF

The aim of this study was to compare the use of beta-tricalcium phosphate (β-TCP) (chronOS) with autogenous bone grafts alone in maxillary sinus elevation surgery. The test samples were β-TCP alone, β-TCP mixed with autogenous bone grafts (1:1), and autogenous bone grafts alone. Twelve maxillary sinuses were grafted with β-TCP (group 1), nine with β-TCP+autogenous bone graft (group 2), and 12 with autogenous bone graft (group 3). After 6 months, biopsies were obtained concurrent to the placement of dental implants; these were subjected to histomorphometric analysis and immunohistochemical analysis for runt-related transcription factor 2 (RUNX2) and vascular endothelial growth factor (VEGF). The average bone formation in group 1 was 46.3±11.6% in the pristine bone region, 47.6±9.9% in the intermediate region, and 44.8±22.1% in the apical region; in group 2, values were 35.0±15.8%, 32.5±13.7%, and 32.8±16.0%, respectively; in group 3, values were 43.1±16.0%, 31.0±13.0%, and 46.1±16.3%, respectively. Immunostaining of samples in group 2 showed high cellular activity and immature bone; this differed from groups 1 and 3, in which mature bone was demonstrated. Thus, this study showed that β-TCP presents the same behaviour as autogenous bone graft, which makes it a good bone substitute.

Preservación de alvéolos mediante fosfato tricálcico beta, con y sin membrana

The present study evaluated the results of the post-extraction socket preservation technique using Beta-Tricalcium Phosphate with and without the use of a non-resorbable membrane. A total of 18 teeth with indication of extraction and socket preservation were selected, with 10 alveoli being treated with Beta-Tricalcium Phosphate combined with a non-resorbable membrane, and the other 8 with Beta-Tricalcium Phosphate only. The width and height of each socket was evaluated using computed tomography, prior to the extraction, and 6 months after the surgery. At the time of performing the surgical technique for installing the implants, histological specimens were taken from the implant site in order to study the graft site 6 months after the dental extraction surgery and alveoli preservation.The use of Beta-Tricalcium Phosphate, whether a membrane is used or not, maintained the alveolar height 6 months after the extraction, while the width of the alveolus only remained in the group without membrane. Histological results showed varying amounts of bone regeneration.

Microstructure, mechanical characteristics and cell compatibility of β-tricalcium phosphate reinforced with biodegradable Fe–Mg metal phase

The use of beta-tricalcium phosphate (β-TCP) ceramic as a bioresorbable bone substitute is limited to non-load-bearing sites by the material׳s brittleness and low bending strength. In the present work, new biocompatible β-TCP-based composites with improved mechanical properties were developed via reinforcing the ceramic matrix with 30vol% of a biodegradable iron–magnesium metallic phase. β-TCP-15Fe15Mg and β-TCP-24Fe6Mg (vol%) composites were fabricated using a combination of high energy attrition milling, cold sintering/high pressure consolidation of powders at room temperature and annealing at 400°C. The materials synthesized had a hierarchical nanocomposite structure with a nanocrystalline β-TCP matrix toughened by a finely dispersed nanoscale metallic phase (largely Mg) alongside micron-scale metallic reinforcements (largely Fe). Both compositions exhibited high strength characteristics; in bending, they were about 3-fold stronger than β-TCP reinforced with 30vol% PLA polymer. Immersion in Ringer׳s solution for 4 weeks resulted in formation of corrosion products on the specimens׳ surface, a few percent weight loss and about 50% decrease in bending strength. In vitro studies of β-TCP-15Fe15Mg composite with human osteoblast monocultures and human osteoblast–endothelial cell co-cultures indicated that the composition was biocompatible for the growth and survival of both cell types and cells exhibited tissue-specific markers for bone formation and angiogenesis, respectively.

Use of beta‐tricalcium phosphate as a reconstructive tool for small bony defects in the mandible

Objective: To determine if the osteoconductive material ChronOS beta-tricalcium phosphate block (beta-TCP) made by Synthes, a synthetic bone substitute made of beta-tricalcium phosphate, is a viable choice for bone grafting. Methods: We prospectively evaluated the use of the beta TCP in a 50-year-old male with a T4N1M0 stage IV squamous cell carcinoma of the right alveolar ridge who underwent wide local excision with segmental mandibulectomy from ramus to ipsilateral parasymphysis and selective neck dissection. The patient was primarily reconstructed with an osseous fibula free flap. His parasymphyseal bone margin was found to be positive on permanent section, and the patient underwent a second segmental mandibulectomy, leaving him with a 2.0 cm anterior defect at the symphysis of the mandible. A beta TCP block was utilized to fill the bony gap in the anterior mandible from the fibula to the native mandible. Results: The patient healed well postoperatively and was started on a soft diet 1 week post op. He started chemoradiation 4 weeks post op. He is now 20 months post op without any evidence of disease, and has maintained his preoperative occlusion. His postoperative CT scan shows bony fusion at the reconstructed site. Conclusions: The beta TCP block is a useful adjunct for the reconstructive surgeon in small mandibular defects <2.0 cm, and osseous growth is still possible even with postoperative chemoradiation therapy. Use of beta-tricalcium phosphate as a reconstructive tool for small bony defects in the mandible Anya Li, MD1 and Tamer Ghanem, MD PhD1 1Department of Otolaryngology Head & Neck Surgery Henry Ford Hospital, Detroit, MI

Experimental posterolateral spinal fusion with beta tricalcium phosphate ceramic and bone marrow aspirate composite graft

Background:Beta tricalcium phosphate is commonly used in metaphyseal defects but its use in posterolateral spinal fusion remains controversial. There are very few published animal studies in which use of beta tricalcium phosphate has been evaluated in the posterolateral lumbar arthrodesis model. Hence we conducted a study to evaluate the potential of composite graft of beta tricalcium phosphate and bone marrow aspirate in comparison to autologous bone graft, when used for posterolateral spinal fusion.Materials and Methods:Single level posterolateral lumbar fusion was performed in 40 adult male Indian rabbits, which were assigned randomly into one of the four groups based on graft materials implanted; a) 3 gm beta tricalcium phosphate plus 3 ml bone marrow aspirate (Group I); b) 3 ml bone marrow aspirate alone (Group II); c) 3 gm beta tricalcium phosphate (Group III) and d) 3 gm autologous bone graft (Group IV). Each group had 10 rabbits. Half of the rabbits were sacrificed by injecting Phenobarbitone intraperitoneally after eight weeks and the remaining after 24 weeks, and were evaluated for fusion by X-rays, computed tomography (CT) scans, manual palpation test and histology.Results:Beta tricalcium phosphate used with bone marrow aspirate produced best results when compared to other groups (P =.0001). When beta tricalcium phosphate was used alone, fusion rates were better as compared to fusion achieved with autologous iliac crest bone graft though statistically not significant (P =0.07). Autologous bone graft showed signs of new bone formation. However, the rate of new bone formation was comparatively slow.Conclusion:Composite graft of beta tricalcium phosphate and bone marrow aspirate can be used as an alternative to autologous iliac crest bone graft.

The use of beta-tricalcium phosphate and bovine bone matrix in the guided tissue regeneration treatment of deep infra-bony defects

The primary goal of bone regeneration procedures with application of various regenerative biologic agents and biomaterials is to facilitate the formation of periodontal tissues lost as a result of periodontitis. The aim of the study was to compare clinical outcome of the guided tissue regeneration (GTR) treatment with the use of beta-tricalcium phosphate and with bovine bone matrix in human deep intra-osseous defects. Twenty-one systemically healthy subjects with moderate to advanced periodontitis, between 30 and 56 years of age, 11 females and 10 males, were selected. Patients having two similar inter-proximal defects with pocket probing depths following initial therapy greater than 5 mm were recruited for the study. Experimental sites were grafted with pure beta-tricalcium phosphate biomaterial (Cerasorb) and a biomembrane, while control sites were treated with bovine-bone hydroxiapatite xenograft (Bio-oss) and a biomembrane. Immediately before surgery and 12 months after surgery, pocket probing depth (PPD), epithelial attachment level (EAL) and gingival recession (GR) were evaluated. In the experimental group PPD amounted to 6.76 +/- 0.83 mm before surgery, and decreased significantly to 2.67 +/- 0.48 mm 12 months following surgery, while in the control group PPD significantly decreased from 7.14 +/- 0.65 mm presurgically to 2.85 +/- 0.57 mm postsurgically. After one year, EAL gain was 2.76 +/- 0.99 mm in the experimental group, and 3.24 +/- 0.16 mm in the control group. After twelve months postoperatively GR amounted to 1.33 +/- 0.79 mm in the experimental group and to 1.05 +/- 0.80 mm in the control group. No statistically significant differences for PPD reduction, EAL gain and GR increase were detected between the groups. Results from the present study indicate that GTR treatment of deep intra-osseous defects with Bio-oss and Cerasorb resulted in clinically and statistically significant improvement of EAL gain and PPD reduction. A GR was slightly increased, with no statistical significance.

多椎間頚椎 OPLL に対するβ-tricalcium phosphate を応用した前側方部分椎体削開術の短期成績

多椎間頚椎 OPLL に対するβ-tricalcium phosphate を応用した前側方部分椎体削開術の短期成績