β-TCP Group Research Articles

Periodontal regeneration following application of basic fibroblast growth factor-2 in combination with beta tricalcium phosphate in class III furcation defects in dogs

The aim of this study was to investigate the effect of tunnel structured β-tricalcium phosphate (β-TCP) on the regenerative potential of basic fibroblast growth factor-2 (bFGF-2) in class III furcation defects in dogs. The furcations of 30 mandibular premolar teeth received: 1) 0.3% bFGF-2 solution in conjunction with β-TCP; 2) 0.3% bFGF-2 solution; and 3) no implant material (Control group). The dogs were sacrificed 8 weeks post-surgery, and healing was evaluated histologically. New bone formation was significantly greater in the bFGF-2/β-TCP group compared to the bFGF-2 solution and Control groups (p<0.01). New cementum formation in the bFGF-2/β-TCP and bFGF-2 solution groups was significantly greater than that in the Control group (p<0.01). These findings suggested that bFGF-2 alone enhances connective tissue attachment in a manner similar to the combination of bFGF-2 and β-TCP. Furthermore, this combination enhances bone formation up to the fornix in class III furcation defects.

Magnesium incorporation into β‐TCP reduced itsin vivoresorption by decreasing parathormone production

Beta-tricalcium phosphate (β-TCP), one of the most widely used bioresorbable materials for bone therapy, can be doped with magnesium ions, generating β-TCMP. The objectives of this work were to evaluate, on a murine dental alveolus grafting model, the biocompatibility of β-TCP and β-TMCP granules by histomorphometric analysis, as well as the impact on plasmatic levels of receptor activator of nuclear factor κB ligand (RANK-L), osteoprotegerin (OPG), osteocalcin, osteopontin, and parathormone (PTH) during bone repair, using Luminex multiplexing technology. After grafting for 42 days, β-TCP grafted group presented higher bioresorption and induced more newly formed bone than β-TCMP (p < 0.05). β-TCP grafting also induced higher plasmatic levels of RANK-L, compared to β-TCMP and control (blood clot) groups at 21st day (p < 0.05). PTH, which remained at low levels in control group, presented a time-dependent increase in grafted groups, attaining significantly higher levels with β-TCP by the 42nd day (p < 0.05). RANK-L/OPG ratio increased on β-TCP group and attained a peak on the 21st day. In conclusion, β-TCP granules were more bioresorbable and osteogenic than β-TCMP granules, and the resorption of both materials might have been affected by osteoclastogenesis modulated by changes in the plasmatic levels of PTH and RANK-L.

Anorganic Bovine-Derived Hydroxyapatite vs β-Tricalcium Phosphate in Sinus Augmentation: A Comparative Histomorphometric Study

The choice of augmentation material is a crucial factor in sinus augmentation surgery. Bovine-derived hydroxyapatite (BHA) and beta-tricalcium phosphate (β-TCP) have been used successfully in sinus augmentation procedures. Choosing one of these materials for sinus augmentation is still controversial. The aim of this clinical study was to compare the biological performance of the new BHA graft material and the well-known synthetic β-TCP material in the sinus augmentation procedure. The study consisted of 23 patients (12 male and 11 female) who were either edentulous or partially edentulous in the posterior maxilla and required implant placement. A total of 23 two-step sinus-grafting procedures were performed. BHA was used in 13 patients, and β-TCP was used in 10 patients. After an average of 6.5 months of healing, bone biopsies were taken from the grafted areas. Undecalcified sections were prepared for histomorphometric analysis. The mean new bone formation was 30.13% ± 3.45% in the BHA group and 21.09% ± 2.86% in the β-TCP group (P = .001). The mean percentage of residual graft particle area was 31.88% ± 6.05% and 34.05% ± 3.01% for the BHA group and β-TCP group, respectively (P = .047). The mean percentage of soft-tissue area was 37.99% ± 5.92% in the BHA group and 44.86% ± 4.28% in the β-TCP group (P = .011). Both graft materials demonstrated successful biocompatibility and osteoconductivity in the sinus augmentation procedure. However, BHA appears to be more efficient in osteoconduction when compared with β-TCP.

Comparison of in vivo bioactivity and compressive strength of a novel superporous hydroxyapatite with beta-tricalcium phosphates

Superporous hydroxyapatite (HAp-S) is a novel bone substitute that contains three-dimensionally interconnected macropores with micropores, which stimulate bone ingrowth into the material. We investigated the in vivo behaviour of HAp-S by comparing its bioactivity and biomechanical properties with beta-tricalcium phosphates (β-TCP). HAp-S or β-TCP was implanted in the lateral femoral condyle of rabbits. In vivo bioactivity of each material, including bone ingrowth and material resorption, was quantitatively evaluated by micro-CT and the ultimate compressive strength of the bone-material composite was also measured. Micro-CT showed that bone ingrowth in the HAp-S group significantly increased over time, while no significant increase was observed after 8 weeks in the β-TCP group. Although both materials showed gradual material resorption, β-TCP resorption was significantly greater than HAp-S. The ultimate compressive strength in the HAp-S group significantly increased over time up to six times its original value, while there was no significant increase in the β-TCP group. These results show that HAp-S resorption is concurrent with bone ingrowth, resulting in increasing compressive strength over 12 weeks. On the other hand, β-TCP resorption is fast but unaccompanied by bone ingrowth; consequently, it remains relatively fragile at least in the early period after implantation. Although these highly porous materials themselves are structurally and mechanically similar, there are significant differences in in vivo behaviour depending on the material composition. These findings should be kept in mind when choosing the highly porous ceramics.

Anorganic bovine-derived hydroxyapatite versus β-tricalcium phosphate in sinus augmentation. A comparative histomorphometric study

Abstract AbstractIntroduction: The choice of augmentation material is a crucial factor in sinus augmentation surgery. Bovine-derived hydroxyapatite (BHA) and beta-tricalcium phosphate (β-TCP) have been used successfully in sinus augmentation procedures. Choosing one of these materials for sinus augmentation is still controversial. The aim of this clinical study was to compare the biological performance of the new BHA graft material and the well known synthetic β-TCP material in sinus augmentation procedure.Material and Methods: The study consisted of 23 patients (12 male and 11 female) who were either edentulous or partially edentulous in the posterior maxilla and required implant placement. A total of 23 two-step sinus grafting procedures were performed. BHA was used in 13 patients and β-TCP was used in 10 patients. After average of 6.5 months of healing bone biopsies were taken from the grafted areas. Undecalcified sections were prepared for histomorphometric analysis. Results: The mean new bone formation was 30.13±3.45% in BHA group and 21.09±2.86% in β-TCP group (p=0.001). The mean percentage of residual graft particle area was 31.88±6.05% and 34.05±3.01% for BHA group and β-TCP group, respectively (p=0.047). The mean percentage of soft tissue area was 37.99±5.92% in BHA group and 44.86±4.28% in β-TCP group (p=0.011).Conclusion: Both graft materials demonstrated successful biocompatibility and osteoconductivity in sinus augmentation procedure. However, BHA appears to be more efficient in osteoconduction when compared to β-TCP.

Effect of basic fibroblast growth factor (FGF-2) in combination with beta tricalcium phosphate on root coverage in dog

Objective. In root coverage treatment, periodontal regeneration in gingival recession-type defects is an important challenge for the periodontist. The aim of this study was to histometrically investigate the effect of combined use of basic fibroblast growth factor (FGF-2) and beta tricalcium phosphate (β-TCP) on root coverage in dogs. Materials and methods. Sixteen adult beagle dogs were used. Buccal gingival recession defects were surgically created bilaterally in the maxillary canines. The defects in each animal were randomly assigned to: (1) an FGF-2 alone (control) group or (2) FGF-2/β-TCP (experimental) group. At 2, 4 or 8 weeks following surgery, specimens were obtained and subjected to microscopic examination and histometric assessment. Results. Inhibition of epithelial down-growth was observed in both groups. At week 2, in the newly formed connective tissue at the coronal portion, the FGF-2/β-TCP group showed significantly greater numbers of proliferating cell nuclear antigen-positive cells than the FGF-2 group (55.8 ± 4.8 vs 12.0 ± 1.4, p < 0.01). In the FGF-2/β-TCP group, new attachment was observed at 8 weeks and the extent of new bone and cementum formation was significantly greater in the FGF-2/β-TCP group than that in the FGF-2 alone group. In both groups, the dentin surface beneath the new cementum presented minor irregularities, but no replacement resorption was observed. Conclusions. FGF-2 used in combination with β-TCP enhances formation of new bone and cementum without significant root resorption in root coverage in this dog model. This combination warrants further investigation in periodontal regeneration in root coverage treatment.

The in vivo osteogenesis of Mg or Zr‐modified silicate‐based bioceramic spheres

The use of bioactive microspheres as bone filling materials has received much attention due to their ability to fill the bone defects with irregular and complex shapes and sizes. Divalent Mg(2+) modified silicate-based diopside (DIOP: CaMgSi(2)O(6)) and tetravalent Zr(4+) modified silicate-based baghdadite (BAGD: Ca(3)ZrSi(2)O(9)) ceramics have shown excellent in vitro bioactivity for potential bone repair application. However, their in vivo osteogenesis has not been systematically investigated. The aim of this study is to prepare DIOP and BAGD ceramic microspheres and investigate their in vivo osteogenesis. DIOP and BAGD ceramic spheres with loose microstructure were successfully prepared. The dissolution ability of two silicate-based bioceramics was investigated by testing the release of SiO 44- ions after soaking them in phosphate buffered saline. The ceramic spheres were implanted into supracondylar site of the femur defects in Wistar rats and the degree of in vivo osteogenesis was evaluated by hematoxylin and eosin (H and E), Safranin O staining, tartrate-resistant acid phosphatase (TRAP) staining, and immunohistochemistry (type I collagen: Col I, osteopontin: OPN) analyses. The results have shown that BAGD spheres induced a higher rate of new bone formation in the defects than did DIOP and β-tricalcium phosphate (β-TCP) spheres. Immunohistochemical analysis showed greater expression of Col I and OPN in BAGD group compared to DIOP and β-TCP groups. The study indicates different ion modification playing an important role to regulate the in vivo osteogenesis of silicate-based bioceramics. BAGD spheres are a promising bone filler material due to their significantly enhanced osteogenesis, compared to β-TCP spheres.

Bone regeneration of canine artificial alveolar clefts using bone-marrow-derived mesenchymal stromal cells and β-tricalcium phosphate: A preliminary study

ObjectiveCleft lip and palate is a congenital disease showing the highest incidence in the maxillofacial field. In this study, bone regeneration in the canine artificial alveolar clefts using bone-marrow-derived mesenchymal stromal cells (MSCs) and β-tricalcium phosphate (β-TCP) was attempted. MethodsArtificial clefts were prepared in 2-year-old dogs and the animals were divided into three groups. Canine MSCs cultured on β-TCP were grafted in the MSCs/β-TCP group. β-TCP without cells was grafted in the β-TCP group. Nothing was grafted in the control group. ResultsSerial X-ray photographs showed that absorption of β-TCP and substitution with bone progressed favorably and regenerated bone had smooth continuity with the surrounding bone in the MSCs/β-TCP group. In contrast, a bone defect remained at 13 weeks after the cleft formation in the other two groups. Bone mineral density of regenerated bone in the MSCs/β-TCP group was between the density of normal bone and that of β-TCP. Bone mineral content of the cleft region in the MSCs/β-TCP group was three times higher than that in the other two groups. Histologically, the artificial bone in the MSCs/β-TCP group showed replacement with bone. In the control group, most of the cleft region was filled with fibrous tissue. ConclusionsBone regeneration using MSCs and β-TCP presents the possibility of a less-invasive new approach to alveolar bone reconstruction.

Treatment of intrabony defects with beta‐tricalciumphosphate alone and in combination with platelet‐rich plasma

The therapeutic efficacy of platelet-rich plasma (PRP) still remains controversial. This study aimed to compare the efficacy of a beta-tricalcium phosphate (β-TCP) and PRP/β-TCP combination both clinically and radiographically. Fourteen chronic periodontitis patients with at least two similar three-walled defects were included in the study. Each patient was randomly treated with both β-TCP (n = 14) and PRP/β-TCP (n = 14) in the same session. Baseline and 6-month evaluations of plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), gingival recession (GR), bleeding on probing, and radiographic intrabony defect depth (RIDD) were assessed statistically. At 6 months, statistically significant reductions of GI, PPD, BOP, and RIDD were observed in both groups. The median values of CAL decreased from 7.0 to 6.0 mm in the β-TCP group (p = 0.002), and 7.5 to 5.0 mm in the PRP/β-TCP group (p < 0.001). No statistically significant difference was detected between the two groups for all clinical indices. After a 6-month healing period, both β-TCP and PRP/β-TCP were found effective in the treatment of three-walled intrabony defects and no additional statistically significant benefits were found with PRP.

β-Tricalcium Phosphate Promotes Bony Fusion After Anterior Cervical Discectomy and Fusion Using Titanium Cages

Retrospective consecutive cohort study. To study the effectiveness of β-tricalcium phosphate (β-TCP) granules as a packing material in the titanium cages for anterior cervical discectomy and fusion (ACDF), compared with the conventional hydroxyapatite (HA) granules. ACDF using titanium cages is a standard procedure for the treatment of cervical spinal degenerative diseases. Synthetic bone substitutes are widely used to pack the titanium cage to augment intervertebral bony fusion, but the efficacy has not been confirmed. Fusion condition was evaluated on lateral radiographs and computed tomography. Complete fusion of the treated segments was defined by three criteria: movement of the spinous process at flexion and extension positions of less than 3 mm, bony bridging between vertebral bodies, and absence of the halo around the titanium cage. The evaluation was performed at 6 months, 1 year, and 2 years after surgery. Intervertebral fusion was studied in patients who underwent ACDF using β-TCP (93 segments of 57 patients) or HA (72 segments of 48 patients) packing of cylindrical titanium cages. Complete fusion rate at 6 months and 1 year was significantly better in the β-TCP group (46% at 6 months and 69% at 1 year) than in the HA group (24% at 6 months and 49% at 1 year), but the rate was similar at 2 years in the β-TCP group (94%) and the HA group (90%). There were no material-related adverse effects. Satisfactory final fusion rates were obtained after ACDF using both β-TCP- and HA-packed titanium cages. β-TCP showed higher fusion rate in the early stage after surgery and can be recommended as a bone substitute for ACDF with titanium cages.

The comparative effectiveness of demineralized bone matrix, beta-tricalcium phosphate, and bovine-derived anorganic bone matrix on inflammation and bone formation using a paired calvarial defect model in rats.

BackgroundIn this study, the effectiveness of Iranian Tissue Bank–produced demineralized bone matrix (ITB-DBM), beta-tricalcium phosphate (βTCP), and Bio-Oss® (Geistlich Pharma AG, Wolhusen, Switzerland) were evaluated and compared with double controls. The main goal was to measure the amount of new bone formation in the center of defects created in rat calvaria. Another goal was to compare the controls and evaluate the effects of each treatment material on their adjacent untreated (control) defects.MethodsIn this study, 40 male Wistar rats were selected and divided into four groups, In each group, there were ten rats with two defects in their calvarias; one of them is considered as control and the other one was treated with ITB-DBM (group 1), BIO-OSS (group2), and βTCP (group 3), respectively. But in group 4, both defects were considered as control. The amount of inflammation and new bone formation were evaluated at 4 and 10 weeks. In the first group, one defect was filled with ITB-DBM; in the second group, one defect was filled with Bio-Oss; in the third group, one defect was filled with βTCP; and in the fourth group, both defects were left unfilled. Zeiss microscope (Carl Zeiss AG, Oberkochen, Germany) and Image Tool® (version 3.0; University of Texas Health Science Center at San Antonio, San Antonio, TX) software were used for evaluation. SPSS Statistics (IBM Corp, Somers, NY) was used for statistical analysis.ResultsMaximum bone formation at 4 and 10 weeks were observed in the ITB-DBM group (46.960% ± 4.366%, 94.970% ± 0.323%), which had significant difference compared with the other groups (P < 0.001). Ranking second was the Bio-Oss group and third, the βTCP group. Bone formation in the group with two unfilled defects was much more significant than in the other controls beside the Bio-Oss and βTCP after 10 weeks (29.1 ± 2.065, 29.05 ± 1.649), while this group had the least bone formation compared with the other controls at week 4 (2.100% ± 0.758%, 1.630% ± 0.668%, P < 0.001).ConclusionOverall, the ITB-DBM group showed the best results, although the results for other experimental groups were unfavorable. The authors conclude that human DBM (ITB-DBM) should be offered as an alternative for bone regeneration in animals, such as horses, as well as in humans, especially for jaw reconstruction. In relation to bone regeneration in control defects, the effect of experimental material on controls was apparent during the initial weeks.

Coverage of gingival recession defects using acellular dermal matrix allograft with or without beta-tricalcium phosphate

The aim of this study was to investigate the effect of beta-tricalcium phosphate (β-TCP) particles in combination with acellular dermal matrix (ADM) allograft in gingival recession. Experimental gingival recession defects were created in beagle dogs and randomly assigned to one of the following groups: ADM, ADM + β-TCP, or coronally positioned flap (CPF; control). Tissues were histologically examined at 4, 8, or 16 weeks following treatment. A greater thickness of gingiva was observed at the sites treated in both the ADM + β-TCP and ADM groups than in the CPF group. The ADM + β-TCP group showed a statistically significant increase in both new bone and cementum formations compared to the ADM group. The results suggest that the combination of β-TCP and ADM is more effective in promoting new bone and cementum formations than ADM graft alone.

Evaluation of the osteoconductivity of α‐tricalcium phosphate, β‐tricalcium phosphate, and hydroxyapatite combined with or without simvastatin in rat calvarial defect

The purpose of this study is to evaluate the osteoconductivity of three different bone substitute materials: α-tricalcium phosphate (α-TCP), (β-TCP), and hydroxyapatite (HA), combined with or without simvastatin, which is a cholesterol synthesis inhibitor stimulating BMP-2 expression in osteoblasts. We used 72 Wistar rats and prepared two calvarial bone defects of 5 mm diameter in each rat. Defects were filled with the particles of 500-750 μm diameter combined with or without simvastatin at 0.1 mg dose for each defect. In the control group, defects were left empty. Animals were divided into seven groups: α-TCP, β-TCP, HA, α-TCP with simvastatin, β-TCP with simvastatin, HA with simvastatin, and control. The animals were sacrificed at 6 and 8 weeks. The calvariae were dissected out and analyzed with micro CT. The specimens were evaluated histologically and histomorphometrically. In α-TCP group, the amount of newly formed bone was significantly more than both HA and control groups but not significantly yet more than β-TCP group. Degradation of α-TCP was prominent and β-TCP showed slower rate while HA showed the least degradation. Combining the materials with Simvastatin led to increasing in the amount of newly formed bone. These results confirmed that α-TCP, β-TCP, and HA are osteoconductive materials acting as space maintainer for bone formation and that combining these materials with simvastatin stimulates bone regeneration and it also affects degradability of α-TCP and β-TCP. Conclusively, α-TCP has the advantage of higher rate of degradation allowing the more bone formation and combining α-TCP with simvastatin enhances this property.

Stability of beat tricalcium phosphate-coated mini-implants in rat tooth sockets

We investigated the potential of the osteoconductive material β-tricalcium phosphate to promote bone healing when coated on a titanium alloy screw implanted in the mandibular tooth socket of a healthy rat. Forty-eight 9-week-old male Wistar rats were divided into three groups: the Blast group, which received blast-treated screws; the βTCP group, which received β-tricalcium phosphate-coated screws; and the Control group, which received mechanically polished screws. Mandibles were removed at 3 or 9 weeks after screw implantation. Screw removal torques were measured using a handheld torque gauge and compared. At both 3 and 9 weeks after implantation, the screw removal torques were significantly greater in the βTCP group than in the Blast and Control groups (p<0.05). Removal torques did not differ significantly between the Blast and Control groups at either time point. These results suggest that a β-tricalcium phosphate coating on screws accelerates osseous healing around the screw and increases the retentive capacity of the screw. A β-tricalcium phosphate-coated implant fitted into the tooth socket immediately after extraction may therefore provide a favorable environment for early loading of implants.

In Vivo Efficacy of Bone Marrow Stromal Cells Coated with Beta-Tricalcium Phosphate for the Reconstruction of Orbital Defects in Canines

To repair the segmental orbital rim defects of dogs with three-dimensional (3D) tissue-engineered constructs derived from culturing autogenous bone marrow stromal cells (BMSCs) on β-tricalcium phosphate (β-TCP) scaffolds. A 25-mm segmental defect on the canine inferior orbital rim was created. BMSCs were isolated and osteogenically induced in vitro, then were seeded onto 3D β-TCP scaffolds and implanted to repair the orbital defects after 5 days of cultivation. The group of noninduced BMSC/β-TCP, β-TCP alone, and the normal inferior orbital rim were set as controls. The orbits of all groups had spiral computed tomography (CT) scans 1, 4, 8, and 12 weeks after surgery. Gross examination, bone density, microCT, and histologic measurements were performed 12 weeks after surgery. The results were analyzed to evaluate the extent of bone repair. Twelve weeks after surgery, CT examination revealed good inferior orbital rim recovery in the induced BMSC/β-TCP group, and the bone density was 0.30 ± 0.03 g/cm(2) with no dominant variance, compared with the normal control (P > 0.05). MicroCT and histologic examination confirmed that the implantations led to good repair of the defects. Pore-like spongy bone surrounded the implants through the section plane, with some residue remaining in the center. In contrast, the noninduced BMSC/β-TCP implants were not fully repaired, and nonunion was evident. The bony density for this group was 0.23 ± 0.07 g/cm(2), which was significantly lower than that of the control group (P < 0.05). The β-TCP group was largely held by fibrous tissues. Engineered bone from induced BMSCs and 3D biodegradable β-TCP can efficiently repair critical-sized segmental orbital defects in dogs.

Effect of piperacillin-tazobactam coated β-tricalcium phosphate for mastoid obliteration in otitis media

Background and objective β-Tricalcium phosphate (TCP) has good biodegradability and osteoconductivity as a scaffold material for bone tissue engineering. Both block and granular forms are available; however, it has been associated with risk of infection and exposure. To this end, the study evaluated the effect of piperacillin-tazobactam coated β-TCPs for mastoid obliteration in otitis media. Materials and methods Ten guinea pigs were divided into the experimental (piperacillin-tazobactam coated β-TCP granules, n = 5) and control groups (uncoated β-TCP granules, n = 5). After mastoid obliteration, transtympanic injection with a saline suspension of lipopolysaccharide established inflammation. The animals were sacrificed 5 weeks later. Tissue sections were stained with hematoxylin and eosin and examined. Results Encapsulation and formation of fibrous capsule by foreign material in the bulla were not evident. The histological evaluation did not reveal inflammatory cells and fibrosis in the piperacillin-tazobactam coated β-TCP group. In contrast, the control group showed numerous inflammatory cells around the implanted uncoated β-TCP granules and incomplete new bone formation. Conclusion β-TCP is an effective carrier material for piperacillin-tazobactam. The use of piperacillin-tazobactam coated β-TCP may be optimal for mastoid obliteration.

The Influence of Hyperbaric Oxygen Treatment on the Healing of Experimental Defects Filled with Different Bone Graft Substitutes

To assess potential effects of hyperbaric oxygen (HBOT) on artificial bone grafts, β - Tricalcium phosphate (β-TCP) and calcium phosphate coated bovine bone (CPCBB) substitutes were applied to standard bone defects in rat tibiae. The control defects were left empty. Half of the animals received 60 minutes of 2.4 atmosphere absolute (ATA) of HBOT. Rats were sacrificed at one, two and four weeks. Bone healing was assessed histologically and histomorphometrically using light microscopy. The periosteum over the bone defects was examined ultrastructurally. Cardiac blood was collected to determine the serum osteocalcin levels. The HBOT increased new bone formation in the unfilled controls and β-TCP groups and significantly decreased cartilage matrix and fibrous tissue formations in all groups. Active osteoblasts and highly organized collagen fibrils were prominent in the periosteum of β-TCP and control groups. Serum osteocalcin levels also increased with HBOT. The healing of defects filled with CPCBB was similar to the controls and it did not respond to HBOT. These findings suggested that the HBOT had beneficial effects on the healing of unfilled bone defects and those filled with β-TCP bone substitute but not with CPCBB, indicating a material-specific influence pattern of HBOT.

Multi-centre, randomized clinical trial on the efficacy and safety of recombinant human platelet-derived growth factor with β-tricalcium phosphate in human intra-osseous periodontal defects

the objective of the study was to evaluate the safety and efficacy of a formulation containing recombinant human platelet-derived growth factor (rhPDGF-BB) and β-tricalcium phosphate (β-TCP) in patients with periodontal defects and to compare it with those of β-TCP alone. in this double-blind, prospective, parallel, active-controlled, randomized, multi-centre clinical trial, 54 patients with periodontal osseous defects were randomly assigned to rhPDGF-BB+β-TCP or β-TCP. Following periodontal surgery, respective implantation was performed. The primary and secondary end points of treatment were evaluated at the third and the sixth month. among the outcome measures, the extent of linear bone growth (p<0.01) and per cent bone fill (p<0.004) at the sixth month over baseline were significantly higher in the rhPDGF-BB+β-TCP group when compared with the β-TCP group. Similarly, it also resulted in significantly higher area under the curve clinical attachment level gain at 0-6 months (p<0.01), CAL gain and greater reduction in probing depth at the third and the sixth month than that with β-TCP treatment alone. The incidence of adverse events was similar in both the groups and no serious adverse events were reported in any of the patients. rhPDGF-BB+β-TCP is safe and effective in the treatment of periodontal defects. It increases bone formation and soft tissue healing (clinicaltrials.gov, number NCT00496847; CTRI No.: CTRI/2008/091/000152).

Comparative study of microstructural remodification to porous β-TCP and HA in rabbits

To assess the remolding ability of repaired bone in hydroxyapatite (HA) and β-calcium phosphate (β-TCP) scaffold, two 75% porosity bioceramics with the same three-dimensional geometry were implanted into femoral condyles of rabbits. Histological and micro-computed tomography (micro-CT) results demonstrated abundant new bone formation in the porous HA scaffold along with indistinctive scaffold degradation. Results also indicated that scaffold resorption in the β-TCP group, which was followed by a replacement with newly formed bone, was significantly higher than that in the HA group. The crosslinking trabeculae remodeled from the mixtures of the newly formed bone and β-TCP scaffold remnants might be helpful to promoting even loading and reducing stress. The bone remodeling pattern resulted from bone formation and scaffold resorption was significantly different for the two bioceramics. The results demonstrated that the 75% porous β-TCP was more suitable for new bone remodification than HA scaffold.

Ceramic bone graft substitute with equine bone protein extract is comparable to allograft in terms of implant fixation: A study in dogs

Background and purpose We studied whether osseointegration and fixation of plasma-sprayed titanium implants grafted with β-TCP granules (Ossaplast) can be improved by adding an osteogenic signal (Colloss E). The results were compared to implants grafted with fresh frozen morselized allograft with and without the Colloss E device.Methods 4 porous-coated Ti implants were placed in the proximal humeri in each of 10 dogs. All implants were surrounded by a 2.5-mm defect, which was grafted with: (A) β-TCP, (B) β-TCP+20 mg Colloss E, (C) allograft, or (D) allograft+20 mg Colloss E. The observation time was 4 weeks.Results Mechanical testing showed that the β-TCP group with Colloss E was twice as well fixed as the control group grafted with β-TCP granules alone, and comparable to both allograft groups. We found that every control implant in the β-TCP grafted group was covered by a dense fibrous membrane. No fibrous tissue was seen in the β-TCP group augmented with Colloss. These implants were well osseointegrated, with new bone covering 10–25% of the implant surface. Both treated groups had increased graft resorption compared to their respective control groups. Colloss E had no effect on new bone formation or fibrous tissue reduction around the allografted implants.Interpretation The Colloss E device improved early osseointegration of implants grafted with β-TCP granules and increased their mechanical implant fixation to the level of allografted implants. The experiment indicates that ceramic bone substitutes may be a viable alternative to allograft when combined with an osteogenic signal such as Colloss E.