Immediate loading of dental implants is only possible if a firm bone-implant anchorage at early stages is developed. This implies early and high bone apposition onto the implant surface. A nanostructured coating material based on an osseoinductive bone grafting is investigated in relation to the osseointegration at early stages. The goal is to transmit the structure (silica matrix with embedded hydroxyapatite) and the properties of the bone grafting into a coating material. The bone grafting substitute offers an osseoinductive potential caused by an exchange of the silica matrix in vivo accompanied by vascularization. X-ray diffraction and transmission electron microscopy analysis show that the coating material consists of a high porous silica matrix with embedded nanocrystalline hydroxyapatite with the same morphology as human hydroxyapatite. An in vitro investigation shows the early interaction between coating and human blood. Energy-dispersive X-ray analysis showed that the silica matrix was replaced by an organic matrix within a few minutes. Uncoated and coated titanium implants were inserted into the femora of New Zealand White rabbits. The bone-to-implant contact (BIC) was measured after 2, 4, and 6 weeks. The BIC of the coated implants was increased significantly at 2 and 4 weeks. After 6 weeks, the BIC was decreased to the level of the control group. A histological analysis revealed high bone apposition on the coated implant surface after 2 and 4 weeks. Osteoblastic and osteoclastic activities on the coating material indicated that the coating participates in the bone-remodeling process. The nanostructure of the coating material led to an exchange of the silica matrix by an autologous, organic matrix without delamination of the coating. This is the key issue in understanding initial bone formation on a coated surface.
In clinical practice, vertebral compression fractures occur after trauma and osteoporosis. Kyphoplasty is a minimally invasive procedure using bone filler material for the treatment of such fractures. A full synthetic injectable bone substitute (SIBS) was manufactured by means of spray drying. The aim of this study was to characterize the SIBS and to analyze the remodelling process during degradation of the biomaterial and new bone formation after implantation. SIBS is an aqueous suspension of donut-like microparticles. These microparticles consist of nanocrystallites of synthetic hydroxyapatite embedded in amorphous silica gel. After implantation of SIBS in a proximal tibial diaphyseal defect in 52 rats, grafts were harvested for subsequent analysis on different days. Newly formed bone originating from endosteum was observed on day 6. Hematomas in the medullary space and cortical wounds disappeared on day 12. The wound region was completely replaced by a composite of newly formed cancellous bone, extracellular matrix, and SIBS. At day 63 the cortical defect was fully healed by bone, while newly formed bone in the medullary space almost disappeared and was replaced with bone marrow. In conclusion, SIBS demonstrated a unique structure with osteoinductive and bioresorbable properties, which induced fast bone regeneration. Therefore, a clinical application of SIBS for kyphoplasty is promising.
Purpose The aim of this study was to examine the in vivo characteristics and levels of integration and degradation of a ready-to-use bone grafting block with elastic properties (elastic block) for the use in surgery. Materials and methods Thirty-six male Wistar rats underwent surgical creation of a well-defined bone defect in the tibia. All created defects – one per animal – were filled with an unsintered nanocrystalline hydroxyapatite embedded either with a non-cross-linked hydrogel carrier (CONT, n=18) or a cross-linked hydrogel carrier (elastic block [EB], n=18) based on polyvinylpyrrolidone (PVP) and silica sol, respectively. The animals were killed after 12 (n=12), 21 (n=12) and 63 days (n=12). The bone formation and defect healing were quantified by histomorphometric measurements made in paraffin sections. Additionally, immunohistochemical (tartrate-resistant acid phosphatase [TRAP] and alkaline phosphatase [aP]), antibody-based examinations (CD68) and energy-dispersive x-ray scattering measurements of silica atom concentration were carried out. Results A larger remaining bone defect area overall was observed in EB after 12 days and 21 days. After 63 days, similar areas of remaining bone defects were found. The amount of the remaining carrier material in EB overall was higher at all times. In CONT no residual carrier material was found at 12 days and later. CD68 analyses showed significantly lower level of CD68-positive marked cells after 21 days in CONT, and nonsignificant differences at 12 and 63 days, respectively. Additionally, a significantly higher level of aP-positive marked cells was observed in CONT after 12 days. Later on, the levels of aP-positive marked cells were slightly higher in EB (21 and 63 days). Furthermore, no significant differences regarding the level of TRAP-positive marked cells in each group were observed. Conclusion The bone substitute (EB) with the cross-linked PVP-based hydrogel carrier leads at the beginning to a higher amount of remaining carrier material and remaining bone substitute. This delayed degradation is supposed to be the reason for the observed lower level of bone remodeling and is caused by the irradiation changes (cross links) in the structure in PVP.
In the field of dental technology, the length of ceramic pontics is limited to avoid mechanical failure. To reduce thermal-induced residual stress within the ceramic, using smaller subcomponents and subsequent bonding with silicate-based glass solder may be a favorable approach. Thus, the bending strength of zirconia compounds bonded with different silicate-based glass solders was investigated. For this purpose, rectangular specimens made of zirconia were bonded by glass solder. Parameters such as the scarf angle (45° and 90°), two different glass solders, as well as the soldering process (pressure and surface treatment) were varied. All specimens were subjected to quasi-static four-point bending tests according to DIN EN ISO 843-1. Additionally, the quality of the glass solder connection was evaluated using μCT and fractography. In the present study, zirconia compounds were sucessful bonded of zirconia compounds using silicate-based glass solder was. No significant differences in terms of bending strength were observed with respect to the different bonding parameters analyzed. The highest bending strength of 130.6 ± 50.5 MPa was achieved with a 90° scarf angle combined with ethanol treatment of the specimens before soldering and an additional application of a pressure of 2 bars in a dental pressure pot before subsequent soldering. Nevertheless, the bending strengths were highly decreased when compared to monolithic zirconia specimens (993.4 ± 125.5 MPa).
Various bone graft substitutes were used in clinical practise in the treatment of bone defects after trauma or osteoporosis. Many synthetic biomaterials were developed in recent years primarily based on hydroxyapatite (HA). NanoBone® is a nanocrystalline hydroxyapatite (HA) embedded in a porous matrix of silica (SiO2). The ratio of HA:SiO2 varied between 76:24 (wt%; NanoBone®) and 61:39 (wt%; Nanobone® S). The two bone substitutes NB and NB S and a natural bovine bone substitute Bio-Oss® (BO) were evaluated by means of implantation in the tibia of the rat. The aim of this study was to analyze the remodelling process and to measure new bone formation and degradation after implantation of these biomaterials. A tibia defect model was used for all investigations with testing periods of 12, 21 and 84 days. (n=5 for each time point). The results showed, that all bone grafts were well accepted by the host tissue without inflammatory reactions. In comparison to the biomaterial BO, NanoBone® and NanoBone® S were quickly degraded, whereas autologous proteins were incorporated into nanopores. New bone formation was statistically higher in NanoBone® S compared to Bio-Oss® in defect area after 84 days implantation. The presence of osteoclasts in tissue sections were demonstrated by TRAP- and ED1-immunohistology.
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