ABSTRACT
Objective Coralline hydroxyapatite (CHA),in comparison with Bio-Oss bone meal,is a material with extensive resources but no immunogenicity or risk of disease-transmission. The aim of this article was to study the clinical application of CHA in ridge preservation in the maxillary anterior zone. Methods Twenty-six patients underwent extraction of maxillary anterior teeth (n=26) for chronic periodontitis or periapical periodontitis. The patients were randomly assigned into a CHA and a control group of equal number to receive ridge preservation with CHA and Bio-Oss bone meal respectively. Cone beam computed tomography (CBCT) was performed immediately and at 4 months after ridge preservation to compare the vertical and horizontal alterations of the alveolar ridge be-tween the two groups of patients. Results After ridge preservation,both the CHA and control groups showed a reduction in the width ([1.1±0.7] vs [1.3±1.9] mm) and height of the alveolar ridge ([1.3±1.6] vs [1.2±1.4] mm),but with no statistically significant differences between the two groups (P<0.05). Conclusion For ridge preservation in the maxillary anterior zone,CHA has a similar effect to that of Bio-Oss bone meal and therefore is an ideal material for bone graft.
ABSTRACT
Objective Bone defect repair remains a challenge in regenerative medicine, which has triggered a research upsurge on improving the bone repairing effect using heterogeneous bone combined with growth factors.The aim of this study was to evaluate local bone formation following surgical implantation of coralline hydroxyapatite (CHA), a heterogeneous bone, in combination with the concentrated growth factor (CGF).Methods This randomized prospective study included 24 New Zealand rabbits, which were equally divided into a CHA/CGF+CHA, a CHA/CGF+autograft and a CHA+autograft group.A defect 10 mm in diameter was made in the parietal bone of each animal and filled with CHA/CGF, CHA or autograft.At 6 and12 weeks after the operation, we observed the bone formation by micro-CT and histological examination.Results The bone volume (BV) was significantly higher in the CHA/CGF+CHA than in the CHA+autograft group both at 6 weeks ([39.00±7.61] vs [32.12±6.55] mm3, P<0.05) and at 12 weeks after the operation ([49.75±2.36] vs [39.45±7.02] mm3, P<0.05), and so was the bone mineral density (BMD) ([308.30±29.82] vs [256.85±151.25] mg/mL, P<0.05;[389.00±31.87] vs [302.53±127.05] mg/mL, P<0.05).Histological examination showed that the new bone was distributed throughout the CHA scaffold in the CGF/CHA group at 6 weeks, and the new bone was observed only in the periphery region of the CHA scaffold in the CHA group.The bone defects in the CGF/CHA group were fully repaired at 12 weeks, while those in the CHA group were partly repaired with bone and fibrous tissue in the central region of the defects.Conclusion Combination of CHA with CGF could effectively enhance bone healing.CHA/CGF compound artificial bone is an ideal substitute in bone transplantation.
ABSTRACT
Objective To evaluate the application value of ultrasound in vascularization of different artificial bones . Methods A total of 15 New Zealand rabbits were utilized for model establishment of classic segmental bone defect in bilateral radius . Recombinant human bonemorphogenic protein-2 ( rhBMP-2 ) coralline hydroxyapatite(CHA) and CHA were implanted into left and right limbs . Each CHA was divided into 4 equal parts which were examined with conventional ultrasonography and contrast-enhanced ultrasonography( CEUS ) on 3 d ,7 d ,11 d ,15 d ,30 d and 45 d respectively . CEUS quantitative was performed by time-intensity curve(TIC) ,which parameters including the basic intensity(BI) ,peak intensity (PI) ,increased signal intensity ( ΔSI) and time to peak ( TTP) . Then the results were analyzed and compared to pathology . Results Within the same duration ,the vascularization degree in rhBMP-2 group was stronger than that in the ordinary group with advanced vascularization time . Positive correlation was detected between ΔSI and time of both groups ( r =0 .938 ,0 .890 ;P =0 .000) ,and negative correlation was found between BI/PI or TTP and time ( BI/PI: r = -0 .798 ,-0 .899 ; P = 0 .000 ;TTP= r -0 .874 ,-0 .868 ;P = 0 .000 ) . No statistical significance was observed among four observation points of both CHA ,which indicated no obvious difference in vascularization degree of each observation point . Conclusions The structure of bone graft can be clearly displayed by conventional ultrasound ,and CEUS is able to show the early blood perfusion in two CHA grafts and to accurately evaluate the difference of CHA microvascular growth before and after rhBMP-2 application . The combination of these two techniques is a promising approach of evaluating bone graft vascularization in clinical practice .
ABSTRACT
INTRODUCCIÓN. El pie plano valgo es una de las afecciones ortopédicas más frecuentes en el niño. El objetivo de este estudio fue estudiar los resultados del tratamiento a 20 niños con pie plano valgo, a los cuales se les realizó una artrodesis extraarticular subastragalina con un fragmento de hidroxiapatita coralina. MÉTODOS. Se realizó un estudio longitudinal prospectivo con 20 pacientes (20 pies) con diagnóstico confirmado de pie plano valgo paralítico infantil, que fueron atendidos en el Hospital Docente Pediátrico del Cerro entre marzo del 2005 y marzo del 2008. Tras un corte preliminar a los 2 años se practicó un tratamiento quirúrgico mediante artrodesis extraarticular subastragalina en 12 pacientes, quienes conformaron el universo de trabajo pues eran los que permitían presentar un análisis preliminar de los resultados obtenidos hasta el momento. RESULTADOS. Los 12 pacientes operados tenían edades comprendidas entre 6 y 12 años. Se obtuvieron resultados satisfactorios en 11 pacientes y regular en 1 paciente, en el cual se produjo una fractura del material implantado, pero mejoró clínicamente el dolor y la deformidad. La valoración de la técnica quirúrgica arrojó un 90 % de resultados buenos y un 10 % de resultados regulares.CONCLUSIÓN. Consideramos la artrodesis extraarticular subastragalina con hidroxiapatita coralina como una alternativa para el tratamiento quirúrgico del pie plano valgo paralítico infantil
INTRODUCTION. The flat valgus foot is one of the more frequent orthopedic affections in children. The objective of present paper was to study the treatment results obtained in 20 children presenting with valgus flat foot underwent subastragalus extra-articular arthrodesis using a fragment of coralline hydroxyapatite. METHODS. A longitudinal and prospective study was conducted in 20 foot's patients diagnosed as a infantile paralytic valgus foot seen in the Children Teaching Hospital of Cerro municipality from March, 2005 to March, 2008. After a preliminary cut at two years authors performed a surgical treatment with subastralagus exra-articular arthrodesis in 12 patients included in the work universe thus they allowing to present a preliminary analysis of results obtained at that moment. RESULTS. The 12 patients operated on were aged between 6 and 12. There were 11 patients with satisfactory results and another patient with regular results and a fracture of the implanted material but clinically improved the pain and the deformity. Assessment of surgical technique yielded a 90 percent of good results and a 10 percent of regular results. CONCLUSION. Subastragalus extra-articular arthrodesis using coralline hydroxiapatite is a considered a good alternative for surgical treatment of infantile paralytic valgus foot
INTRODUCTION. Le pied plat valgus est l'une des affections orthopÚdiques les plus souvent trouvÚes chez l'enfant. Le but de cette Útude a ÚtÚ d'Útudier les rÚsultats du traitement de 20 enfants atteints de pied plat valgus, lesquels ont ÚtÚ traitÚs par arthrodÞse extra-articulaire sous-astragalienne avec un fragment de hydroxyapatite corallienne. MÉTHODES. Une Útude longitudinale prospective de 20 enfants (20 pieds) avec diagnostic confirmÚ de pied plat valgus et paralytique, et traitÚs Ó l'H¶pital pÚdiatrique universitaire Ó Cerro, entre mars 2005 et mars 2008, a ÚtÚ rÚalisÚe. AprÞs une coupe au bout des 2 ans, douze patients ont ÚtÚ chirurgicalement traitÚs par arthrodÞse extra-articulaire sous-astragalienne, ce qui a permis de prÚsenter une analyse prÚliminaire des rÚsultats obtenus jusqu'au moment. RÉSULTATS. Les 12 patients opÚrÚs Útaient ÔgÚs de 6 Ó 12 ans. Il y a eu des rÚsultats satisfaisants chez 11 patients, et des rÚsultats mÚdiocres chez un seul patient, due Ó une fracture du matÚriel implantÚ, mais dont la douleur et la dÚformation ont amÚliorÚ. L'Úvaluation de cette technique chirurgicale a montrÚ 90 percent de bons rÚsultats et 10 percent des rÚsultats mÚdiocres. CONCLUSIONS. Nous considÚrons l'arthrodÞse sous-astragalienne avec hydroxyapatite corallienne un traitement chirurgical alternatif pour le pied plat valgus et paralytique chez l'enfant
ABSTRACT
Objective:To evaluate the periodontal tissue regeneration effect of implantation of bone marrow stromal cells(BMSCs)-root-coralline hydroxyapatite(CHA) complex.Methods:BMSCs of beagle dogs were in vitro cultured on CHA scaffold and on tooth root surface respectively.Then BMSCs-root samples were inserted into BMSCs-CHA scaffolds to form BMSCs-CHA-root complexes.5 complexes were implanted on one side of mandible in each of the dogs 1 month after the 4th,5th and 6th teeth had been extracted.Root-CHA without BMSCs was implanted on another side as the control.All dogs were killed 16 weeks after implantation,and the periodontal tissue regeneration were observed histologically.Results:More new bone formation and more mature alveolar bone were observed in the test group than that in the control,and there was a clearly periodontal ligament-like tissue formation only in the test group.Conclusion:The complex of BMSC-root-CHA can improve the periodontal tissue regeneration.