The aim of this work was to develop a bioactive bone substitute with an effective antibacterial ability based on a cerium (Ce) doped glass-reinforced hydroxyapatite (GR-HA) composite. Developed composites were physicochemically characterized, using x-ray diffraction (XRD) analysis, SEM, energy dispersive x-ray spectroscopy (EDS), and flexural bending strength (FBS) tests. X-ray photoelectron spectroscopy (XPS) analysis was performed to analyze the oxidation state of Ce in the prepared doped glass. The antimicrobial activity of the composites was evaluated against Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa; whether the cytocompatibility profile was assayed with human osteoblastic-like cells (Mg-63 cell line). The results revealed that the Ce inclusion in the GR-HA matrix induced the antimicrobial ability of the composite. In addition, Ce-doped materials reported an adequate biological behavior following seeding of osteoblastic populations, by inducing cell adhesion and proliferation. Developed materials were also found to enhance the expression of osteoblastic-related genes. Overall, the developed GR-HA_Ce composite is a prospective candidate to be used within the clinical scenario with a successful performance due to the effective antibacterial properties and capability of enhancing the osteoblastic cell response.

Cell adhesion of MG63 osteoblastic cells seeded over GR-HA_control and Sm doped composites, at day 1 of culture. Low (A) and high (B) CLSM images of cells stained for F-actin cytoskeleton (green) and nuclei (red); (C) SEM images.

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Two synthetic calcium phosphates in porous wedge shape, Bonelike and a commercial HA/beta-TCP biphasic material, were used as an alternative to bone autografts and allografts in the treatment of medial compartment osteoarthritis of varus knees. The structure of Bonelike has a 3D architecture that is computer controlled, and a composition that mimics the mineral composition of natural bone. The HA/beta-TCP biphasic material used as a control material in this study was prepared using conventional foaming based methods. No signs of inflammatory reactions were observed post-operatively for both materials. After 4 months signs of fusion at the osteotomy site and good integration of the implanted wedges were observed, showing good mechanical resistance. Concerning the final correction attained, the left knee revealed a satisfactory valgus of 10 degrees , but the right one only had a final value of 6 degrees . The clinical evaluation using International Knee Score (IKS) showed good outcome in all parameters with complete range of motion in both knees and climbing stairs without crutches with only slight pain.

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The objective of this study is to evaluate the osteoconductivity and bioactivity of the Bonelike Õ graft in repairing surgical cystic bone defects. Bonelike Õ is implanted in 11 patients, aged between 24 and 53 years with a mean age of 36 years, consisting of 5 men and 6 women. According to the standard follow up protocols, radiological examinations are performed and Bonelike Õ /bone retrieved samples have been analyzed histologically using nondecalcified sections obtained perpendicular to bone length axis. Radiographic examination and histological results clearly demonstrate an extensive new bone formation apposed on Bonelike Õ granules with a significant degree of maturation. These clinical applications in maxillary bone defects indicate perfect bone bonding between new bone formed and Bonelike Õ granules, along with partial surface biodegradation. This quick and effective osteoconductive response from Bonelike Õ may reduce the time needed to reconstruct the bone defected area of patients.

Silver oxide doped lead lithium borate (LLB) glasses have been prepared and characterized. Structural and composition characterization were accessed by XRD, FTIR, Raman, SEM and EDS. Results from FTIR and Raman spectra indicate that Ag(2)O acts as a network modifier even at small quantities by converting three coordinated to four coordinated boron atoms. Other physical properties, such as density, molar volume and optical basicity are also evaluated. Furthermore, they are also affected by the silver oxide composition.