Osteoinductive calcium phosphate with submicron topography as bone graft substitute for maxillary sinus floor augmentation: A translational study

Abstract

Objectives The aim of this study was the preclinical and clinical evaluation of osteoinductive calcium phosphate with submicron surface topography as a bone graft substitute for maxillary sinus floor augmentation (MSFA). Material and Methods A preclinical sheep model of MSFA was used to compare a calcium phosphate with submicron needle‐shaped topography (BCPN, MagnetOs Granules, Kuros Biosciences BV) to a calcium phosphate with submicron grain‐shaped topography (BCPG) and autologous bone graft (ABG) as controls. Secondly, a 10‐patient, prospective, randomized, controlled trial was performed to compare BCPN to ABG in MSFA with two‐stage implant placement. Results The pre‐clinical study demonstrated that both BCPN and BCPG were highly biocompatible, supported bony ingrowth with direct bone apposition against the material, and exhibited bone formation as early as 3 weeks post‐implantation. However, BCPN demonstrated significantly more bone formation than BCPG at the study endpoint of 12 weeks. Only BCPN reached an equivalent amount of bone formation in the available space and a greater proportion of calcified material (bone + graft material) in the maxillary sinus compared to the “gold standard” ABG after 12 weeks. These results were validated in a small prospective clinical study, in which BCPN was found comparable to ABG in implant stability, bone height, new bone formation in trephine core biopsies, and overall clinical outcome. Conclusion This translational work demonstrates that osteoinductive calcium phosphates are promising bone graft substitutes for MSFA, whereas their bone‐forming potential depends on the design of their surface features. Netherlands Trial Register, NL6436.

Composite bone graft of CaO–MgO–SiO2 glass–ceramics and CaSO4 ceramics for boosting bone formation rate

“…, angiogenesis), and the growth of bones. 44,45 This is possibly attributed to the porosity in the hybrid-pore (CMS) 1.5 (CS) 1.5 and submicron-pore (CMS) 1.5 (CS) 1.5 substitutes, which are 82.85% and 71.38%, respectively, as shown in Table S2 (ESI†). The higher porosity in the bone graft allows more cells or blood vessels to penetrate into the empty area for bone regeneration.…”

“…To enhance the osteoinductive properties of the bone graft, some research demonstrated a significant influence of the surface structure of the bone grafts to the behavior of macrophages (i.e., a type of immune cell), the formation of blood vessels (i.e., angiogenesis), and the growth of bones. 44,45 This is possibly attributed to the porosity in the hybrid-pore (CMS) 1.5 (CS) 1.5 and submicron-pore (CMS) 1.5 (CS) 1.5 substitutes, which are 82.85% and 71.38%, respectively, as shown in Table S2 (ESI †). The higher porosity in the bone graft allows more cells or blood vessels to penetrate into the empty area for bone regeneration.…”

Optimization of a tunable process for rapid production of calcium phosphate microparticles using a droplet-based microfluidic platform

“…The superior osteoinductivity of autografts is associated with specialized bone cells, growth factors, and a functional vascular network they contain. Tailoring physicochemical properties of CaPs, such as chemical composition, surface topography and microstructure, was shown to be effective in engineering CaPs with advanced osteoinductivity and bone-forming ability ( Davison et al, 2014 ; Tang et al, 2018 ; van Dijk et al, 2023a ; van Dijk et al, 2023b ). This requires investigating a large design space to find the synthesis and processing parameters that lead to CaPs with optimal physicochemical properties that in turn result in effective biomaterials-induced bone healing.…”