Histological and scanning electron microscopy analyses of bone/implant interface using the novel Bonelike® synthetic bone graft

Abstract

Synthetic bone grafts provide an alternative to autografts and allografts. Bonelike 1 is a patented synthetic bone graft that mimics the mineral composition of bone. The aim of the present work was to assess the biological behavior of Bonelike 1 graft in humans, before using the material in orthopedic applications of bone regeneration, for example, in opening wedge high tibial osteotomies for medial knee osteoarthritis. Bonelike 1 granules were implanted in cortical bone of 11 patients undergoing osteotomies, and new bone formation, osteoconductive properties, and resorption characteristics of the granules were analyzed. The granules ranged from 500 to 1000 mm and were implanted in the lateral aspect of the tibia. The patients' mean age was 59 years (range 48 to 70 years); there were eight women and three men, all suffering from medial compartment osteoarthritis of the knee. At surgery, a 1 Â 1 Â 1-cm cortical defect was created 3 cm distal to the entry point of the screws, in line with the long axis of tibia. The implanted Bonelike 1 graft sample was extracted for analysis during removal of the metallic prosthesis after implantation times of 6, 9, and 12 months. Radiological follow-up, scanning electron microscopy, histological analysis, and histomorphometric measurements were conducted on the retrieved samples to assess bone regeneration in the defect area. Osteoconductive capacity was demonstrated by extensive mature bone formation around the implanted granules and high levels of percentage bone-to-graft contact (from 67-84%). Bonelike 1 acted as an excellent bioactive scaffold, allowing the migration, proliferation, and differentiation of bone cells on its surface, and therefore regeneration of the defects was achieved in a rapid, controlled manner. Our results suggest that Bonelike 1 graft is an excellent candidate for orthopedic applications where rapid new bone formation is a fundamental requirement. ß

In Vivo Biocompatibility of β Tri-calicum Phosphate Versus White Portland Cement in Mandibular Bone Surgical Defect in Dogs

“…All result of this study showed a pattern of bone formation in WPC similar to the result of other studies testing many grafts [36,37] . This pattern of bone formation which start from the wall of the bone defect toward the center, suggests that the WPC material is biocompatible and osteoconductive.…”

Cell-induced response by tetracyclines on human bone marrow colonized hydroxyapatite and Bonelike®

“…1), and the ongoing release/deposition events of Ca and P ionic species leads to the rapid formation of an apatite layer, according to previous studies [39]. This behavior appears to contribute to the improved biological performance of Bonelike Ò , both in vitro [40,41] and in vivo [22,42,43]. In comparison, formation of an apatite layer on the surface of HA occurs slowly [39], with favorable surface conditions for cell growth being observed later.…”

In vivo systemic toxicity assessment of an oxidized dextrin‐based hydrogel and its effectiveness as a carrier and stabilizer of granular synthetic bone substitutes

“…73,74 Furthermore, the presence of glass in this formulation allows the introduction of several ions into BL composition, such as magnesium, fluoride, and sodium, making it possible to achieve a chemical composition closer to the mineral phase of the bone. [76][77][78][79] However, clinical applications were often performed using autologous blood as a carrier for the granules, which raises the need for a more adequate and less invasive vehicle to better stabilize the granules in large defects or unstable sites, avoiding dispersion or medullar infiltration. [76][77][78][79] However, clinical applications were often performed using autologous blood as a carrier for the granules, which raises the need for a more adequate and less invasive vehicle to better stabilize the granules in large defects or unstable sites, avoiding dispersion or medullar infiltration.…”

“…75 Clinical trials revealed its remarkable potential of osteoconductivity and osseointegration on orthopedic and dental applications. [76][77][78][79] However, clinical applications were often performed using autologous blood as a carrier for the granules, which raises the need for a more adequate and less invasive vehicle to better stabilize the granules in large defects or unstable sites, avoiding dispersion or medullar infiltration. Moreover, the development of a moldable/injectable formulation will increase the diversity of clinical cases in which BL can be applied.…”