Research on the surface structure of a dentin matrix with complete demineralization and incomplete demineralization and the osteogenic property promotion of human periodontal ligament cells / 口腔疾病防治

Objective@# To analyze the different fabrication methods and surface structure of treated dentin matrix (TDM) and demineralized dentin matrix (DDM) and their diverse function on promoting the proliferation and osteogenic differential capability of human periodontal ligament cells (hPDLCs). This study provides a preliminary basis for the treatment of periodontal bone defects with bone substitutes from teeth.@*Methods@#TDM was made from human dentin matrices and demineralized incompletely by soaking in different concentrations of ethylene diamine tetra-acetic while DDM was made of human dentin matrices and demineralized completely by soaking in a hydrochloric acid solution followed by observation via SEM. The liquid extracts of TDM and DDM were collected according to the protocol of the International Standardization Organization (ISO 10993). Then, hPDLCs were divided into the following three groups: the TDM group (liquid extracts of TDM), the DDM group (liquid extracts of DDM), the control group (a-modified eagle medium with 10% fetal bovine serum), hPDLCs were cultured with liquid extracts of TDM or DDM, or a-modified eagle medium with 10% FBS). hPDLC proliferation was detected by a Cell Counting Kit-8 (CCK-8). The alkaline phosphatase (ALP) expression and calcified nodules of hPDLCs were tested.@*Results @#TDM obtained a preferable surface structure compared to DDM due to more sufficiently exposed dentinal tubules and looser fiber bundles of the intertubular and peritubular dentin. Both TDM and DDM promoted the proliferation of hPDLCs compared with the control group, and the proliferation of hPDLCs was significantly greater in the TDM group compared to the DDM group (F = 36.480, P < 0.05). The ALP activity of hPDLCs in the TDM group was higher than the DDM group. After a 14-day osteogenic induction, Alizarin red staining mineral nodes were observed in both groups; however, the TDM group displayed more calcified nodules than the DDM group.@*Conclusion@#The advantages of TDM including the surface structure, proliferation and osteogenic differentiation of hPDLCs, are more prominent than those of DDM, suggesting that TDM is a potential promising bone graft substitute in periodontal regeneration.

Evaluation of the early clinical effect of medical calcium sulfate in traumatic fracture treatment / 实用医学杂志

Objective To investigate the X-ray gray scale changes of calcium sulfate and evaluate its clini-cal effect in traumatic fracture treatment. Methods 23 traumatic fracture cases were treated from September 2014 to January 2016 in our hospital. The degradation rate of calcium sulfate was evaluated by X ray assay. Results Af-ter surgery,about 69%remnants at 1 week,53%remnants at 2 weeks,26%remnants at 4 weeks,7%remnants at 6 weeks were observed,while no remnants were found at 8 weeks after surgery. The initial time window of callus appearance was 3 to 9 weeks and the mean time was(6.5 ± 1.6)weeks. The fracture union time was 8 to 24 weeks and the mean time was(15.0 ± 5.2)weeks. One patient with distal humeral comminuted fracture had non-infec-tious delayed healing wound.One case of hemolytic staphylococcus in incision was cultured. Conclusion Calcium sulfate degrades rapidly,cautions should be taken for the application in the superficial bone.

The efficacy of the combination of improved intramedullary VSD drainage and contained antibiotics bone graft to treat chronic tubular bones osteomyelitis / 中华显微外科杂志

Objective To investigate the efficacy of the combination of improved intramedullary VSD drainage and contained antibiotics bone graft to treat chronic tubular bones osteomyelitis.Methods From March,2011 to December,2013,our department have total of 40 patients with chronic tubular bones osteomyelitis.Twenty cases (group A) treat with one-stage osteomyelitis debridement cortical bone slotted,contained antibiotic bone and autologous bone implants and wound repair.Twenty cases (group B) treat with improved intramedullary VSD drainage 3-5 days temporarily after osteomyelitis debridement cortical bone slotted,then contained antibiotic bone and autologous bone implants and wound repair.A retrospective comparison of two groups of an average residence time of wound drainage postoperative,bone bed bacterial culture positive rate,average healing time,the average time of hospital stay,the average bone healing time,and recurrence rate of osteomyelitis.Statistical analysis with T test was used for above independent parametric.Results The two groups were followed-up for 6-24 months,independent samples t-test was used for two groups in the wound healing time,bone healing time,the drainage tube removal time and the length of hospital stay,in group A bone bed bacteria culture positive rate was 40％,group B was 5％,group A infection relapse has 2 cases,1 case was debridement cured,1 case was amputation,and the recurrence rate of 10％.Group B without infection recurrence,and the recurrence rate of 0％ ; The healing time and hospital stay of intramedullary drainage surgery patients (18.05 ± 2.74 d and 22.65 ± 2.80 d,respectively,in group B) was significantly less than one-stage surgery patients (24.10 ± 8.20 d and 28.10 ± 9.35 d,respectively,in group A),but the bone healing time and the drainage tube removal tine of two groups.There was no significant difference (P ＞ 0.05).Conclusion Contained antibiotic bone and autologous bone implants with wound healing therapy after osteomyelitis debridement cortical bone slotted with improvement VSD intramedullary drainage to treat patient with tubular bones osteomyelitis was more effective,it worthy of clinical spread.

Artrodese na coluna cervical utilizando SICAP como substituto de enxerto ósseo / Artrodesis en la columna cervical utilizando SICAP como sustituto de injerto óseo / Cervical spine fusion utilizing silicated calcium phosphate bone graft substitute SICAP

OBJETIVO: Substitutos de enxerto ósseo autólogo foram desenvolvidos para evitar as complicações da retirada de enxerto ósseo autólogo. SiCaP (Actifuse, ApaTech EUA, Reino Unido) é um enxerto ósseo composto de cálcio-fosfato com um substituição de silicato na estrutura química, com uma estrutura tridimensional que parece osso natural. MÉTODOS: 19 pacientes foram submetidos à fusão óssea cervical e analisados retrospectivamente. A avaliação radiográfica e avaliação clínica foram realizadas utilizando o questionário Neck Disability Index e a escala análoga da dor (VAS) pré- e pós-operação. RESULTADOS: O período médio de acompanhamento pós-operatório foi de 14 meses ± 5 meses (7-30 meses). 11 pacientes foram submetidos à fusão via anterior; 5 pacientes via posterior e 3 pacientes via anterior e posterior. A revisão radiográfica mostrou 19/19 (100 por cento) de fusão óssea, nenhum caso apresentou subsidência, quebra ou soltura de material de implante ou movimento nos níveis fusionados. Nenhum exemplo de ossificação heterotópica ou de crescimento ósseo intracanal foi observado. Clinicamente, os escores médios do Neck Disability decresceram 13,3 pontos (media pré-op. de 34,5, pós-op. de 21,2, melhora de 39 por cento), a média da VAS para dor cervical decresceu 2 pontos (2,7 pré-op para 0,7 pós-op.; melhora de 74,1 por cento). Não foram observadas complicações como infecção, osteólise ou edema excessivo das partes moles. CONCLUSÃO: Os resultados preliminares obtidos nesta série foram encorajadores com o uso do SICaP como enxerto ósseo, com sólida fusão óssea obtida em todos os casos e sem formação de ossificação heterotópica ou crescimento de osso intracanal. SIcaP demonstra ser um substituto confiável para o enxerto ósseo autólogo na coluna cervical.

OBJECTIVE: Bone graft substitutes have been developed to obviate the need for autograft from the iliac crest and its resultant complications. SiCaP (Actifuse, ApaTech US, UK) is a calcium phosphate bone graft substitute with selective controlled silicate substitution in a patented 3-dimensional structure resembling natural bone. METHODS: 19 patients who underwent cervical spine fusion were retrospectively reviewed. Radiographic evaluation and clinical evaluation were performed using Neck Disability Index questionnaire and Visual Analog Scale (VAS) pre- and post-operatively. RESULTS: The mean post-operative follow-up was 14 ± 5 months, range 7-30 months. Eleven patients had an anterior approach, five patients had a posterior approach, and 3 had combined anterior-posterior approaches. Radiographic review showed 19/19 (100 percent) patients were considered fused, with no subsidence, hardware breakage, or hardware loosening. No instances of heterotopic bone formation or intracanal boney ingrowths were observed. Clinically, average Neck Disability scores decreased 13.3 points (pre-op 34.5, post-op 21.2, a 39 percent improvement); average VAS neck pain scores decreased 2.2 points (4.9 pre-op to 1.9 post-op; a 44.9 percent improvement; average VAS arm pain decreased 2.0 points (2.7 pre-op to 0.7 post-op, a 74.1 percent improvement). There were no complications such as infection, osteolysis, or abnormal swelling of soft tissues. CONCLUSIONS: Preliminary results from this series with the use of SiCaP bone graft substitute were encouraging, with solid fusion occurring in all subjects, and no heterotopic bone formation or intracanal bone ingrowths. SiCaP seems to be a reliable alternative to autograft on cervical spine fusion achieving solid fusion with no complications.

OBJETIVO: Sustitutos de injerto óseo autólogo fueron desarrollados para evitar las complicaciones de la recogida de injerto óseo autólogo. SiCaP (Actifuse, ApaTech EE.UU, Reino Unido) es un injerto óseo compuesto de calcio-fosfato con una sustitución de silicato en la estructura química, con una estructura tridimensional que parece hueso natural. MÉTODOS: 19 pacientes fueron sometidos a fusión ósea cervical y analizados retrospectivamente. La evaluación radiográfica y la evaluación clínica fueron realizadas utilizandose el cuestionario Neck Disability Index y la escala análoga del dolor (VAS) pre y postoperación. RESULTADOS: El período promedio de seguimiento postoperatorio fue de 14 meses ± 5 meses (7-30 meses). Once pacientes fueron sometidos a fusión vía anterior; 5 pacientes vía posterior y 3 pacientes vía anterior y posterior. La revisión radiográfica mostró 19/19 (100 por ciento) de fusión ósea, ningún caso presentó subsidencia, rotura o soltura de material de implante o movimiento en los niveles fusionados. Ningún ejemplo de osificación heterotópica o de crecimiento óseo intracanal fue observado. Clínicamente, el promedio de las puntuaciones del Neck Disability disminuyeron 13,3 puntos (promedio preop. de 34,5, postop. de 21,2, mejora de 39 por ciento), el promedio de VAS para dolor cervical disminuyó 2 puntos (2,7 preop. para 0,7 postop.; mejora de 74,1 por ciento). No fueron observadas complicaciones como infección, osteólisis o edema excesivo de las partes blandas. CONCLUSIÓN: Los resultados preliminares obtenidos en esta serie feuron estimulantes con el uso de SICaP como injerto óseo, con sólida fusión ósea obtenida en todos los casos y sin formación de osificación heterotópica o crecimiento de hueso intracanal. SIcaP demuestra ser un sustituto confiable para el injerto óseo autólogo en la columna cervical.

Effect on surrounding tissue and bone regeneration by citrated calcium sulphate and osteoset~ tablets / 中国矫形外科杂志

[Objective]To explore the effects on surrounding tissue and bone regeneration by citrated calcium sulphate(CCaS) and Ostesset~.[Method]Bilateral or lateral femoral condyles were drilled into defects in 18 rabbits,and divided into 3 groups: A,12 rabbits,left defect filled with CCaS cylinder,right defect with osteoset~;B,3 rabbits,left defect with CCaS,right defect blank;C,3 rabbits,left defect with osteoset~GFDA3,right defect blank.The rabbits were sacrificed at 3 wks,6 wks and 13 wks,and defect samples were taken for histological exam,roengenographic observation and bone tissue calculation by image-plus CCD system.[Result]The defects that were not grafted were filled with bone marrow and there was minimal new bone,only at the margen of the defects CCaS and osteoset~GFDA3 implanted in the defects were gradually absorbed,and substituted by new bone trabecula,which became more mature and thicker.The area fraction and trabecula thickness of new bone in defects treated with CCaS were not significantly different from defects treated with osteoset~ after 3,6,13 wks.However,the degradation velocity of CCaS was slower than that of osteoset~.No inflammatory and foreign body response was observed.[Conclusion]Just like osteoset~,CCaS is more benefitial to new bone formation compared with osteoset~,because CCaS has relatively slower degradation velocity.

Osteogenetic ability of calcium sulfate applied in rabbit lumbar spinal fusion model / 中国矫形外科杂志

[Objective]To investigate the osteogenetic ability of calcium sulfate applied alone by comparing with that of autograft harvested from ilium crest and discuss the possible osteogenetic mechanism.[Method]A rabbit lumbar posterolateral spinal fusion model was established.The left zygapophyseal joint was implanted with calcium sulfate tablet,and the right with iliac crest bone graft.Radiographic analysis and decalcified histological evaluation were performed.[Result]At 3 weeks,residual calcium sulfate tablet could not be noted by X-ray and CT scan,while autograft can't be seen,histological assessment revealed the degeneration velocity of calcium sulfate was slower than that of autograft.Ingrowth of blood vessel tissue and osteo-blast could be seen in both sides.At 6 weeks,there were no difference between both sides,histological assessment revealed cartilage formation in both sides.At 12 weeks,there was no difference by radiographic and histological assessment between both sides,proliferative bone formation was similar with lumbar body.[Conclusion]Calcium sulfate plays the similar role to iliac crest bone graft when used alone in promoting spinal fusion in rabbit model.Calcium sulfate has good osteo-conductivity,perhaps has osteo-inductivity,so is a good bone graft substitute.

Application of Osteoset artificial bone implantation in surgical treatment of spinal tuberculosis / 中国矫形外科杂志

[Objective]To assess the safety and clinical result of Osteoset artificial bone and autogenetic bone grafting ccmbined with internal fixation after radical debridement in the treatment of spinal tuberculosis.[Method]From April 2004 to May 2006,24 cases with spinal tuberculosis were treated with radical debridement,Osteoset artificial bone and autogenetic bone grafting combined with internal fixation.Radiographs(X-rays and CTs) were analyzed to access bony fusion and deformity correction.[Result]All the patients acquired satisfactory incision healing without fever.The follow-up period ranged from 6 to 24 months(mean 15 months).There was no recurrence of the disease or loose instrumentation.The average Cobb's angle correction was(15.2??6.7?).The rate of fusion was 95.8% 3 month after operation,while it was 100% 6 month after operation.[Conclusion]Osteoset artificial bone can avoid the complications of donor bone site.The early clinical outcome is satisfying.

Evaluation of Osteosynthesis in CaO-SiO2-P2O5-B2O3 Glass-ceramics by Posterolateral Fusion of Rabbit Lumbar vertebrae / 대한척추외과학회지

STUDY DESIGN: A comparative in vivo study between ceramics with different compositions. OBJECTIVES: To compare the biodegradation and osteoconduction properties of CaO-SiO2- P2O5- B2O3 glass-ceramics and Cerabone(R)-AW. Summary of Literature Review: Bioglass ceramics can be used as bone graft substitutes. However, no study has been undertaken to investigate the possibility of CaO-S i O2-P2O5-B2O3 glass-ceramics as a bone graft substitute. MATERIALS AND METHODS: Porous CSPB2 implants (44.07% CaO, 40.28% SiO2, 8.1% P2O5 and 5.0% B2O3), porous CSPB3 implants (43.76% CaO, 43.41% SiO2, 4.05% P2O5 and 7.5% B2O3) and porous Cerabone(R)-AW were prepared by the polymer sponge method. Single-level posterolateral spinal fusions were performed on sixty New Zealand white male rabbits. The animals were divided into four groups (9 of autograft, 17 per 3 kind of porous implant group) according to the implant material used: autograft, CSPB2, CSPB3 and Cerabone(R)-AW. Radiographs were performed every two weeks. All animals were sacrificed 12 weeks after surgery. Manual palpation and uniaxial tensile strength were determined. The proportion of the area occupied by the ceramics in the final compared to the initial radiographs was calculated. Decalcified and undecalcified histological sections were evaluated by light microscopy. RESULTS: Fifty one rabbits were evaluated. The union rates were 100 (9 out of 9), 80 (8 out of 8), 81.1 (9 out of 11) and 90.9% (10 out of 11) in the autograft, Cerabone(R)-AW, CSPB2 and CSPB3 groups, respectively. The proportion of the area occupied by Cerabone(R)-AW (90.8 % +/- 14.0) was significantly higher than for CSPB2 (73.1% +/- 11.5) and CSPB3 (73.5% +/- 10.0)(p=0.0011). The mean values of the tensile strengths of Cerabone(R)-AW (214. +/- 57.3N), CSPB2 (214. +/- 57.3 N) and CSPB3 (217 +/- 70.1 N) were not significantly different (p>0.05). CONCLUSION: CSPB2 and CSPB3 had similar tensile strengths and fusion rates of the fusion masses as those of Cerabone(R)-AW; however, they degraded more rapidly than Cerabone(R)-AW. These findings suggest that CSPB2 and CSPB3 grafts can be used as a more ideal new bone graft substitutes than Cerabone(R)-AW.

Porous Beta-Calcium Pyrophosphate as a Bone Graft Substitute in a Canine Bone Defect Model / 대한정형외과학회잡지

PURPOSE: To evaluate the possibility of using porous beta-calcium pyrophosphate (beta-CPP) as a bone graft substitute by comparing its osteoconduction and degradation with porous hydroxyapatite (HA). MATERIALS AND METHODS: Porous HA and porous beta-CPP were implanted in the proximal tibia of 7 dogs. Two animals were sacrificed at 8weeks and 5 animals were sacrificed at 20 weeks after surgery. Radiographs and histologic sections were evaluated. RESULTS: The mean period required for the radiolucent zone to disappear was 7.1+/-1.1 weeks in HA and 6.4+/-1.1 weeks in beta-CPP. By serial radiography, resorption was more prominent in porous beta-CPP than in porous HA at 8 weeks (p=0.04) and at 20 weeks. The proportion of bony tissue in the pore was 16.8% in HA and 29.7% in -CPP. The proportion of pores with bony tissue was 70.2% in HA and 62.5% in beta-CPP at 8 weeks. CONCLUSION: In beta-CPP, the new bone growth was as vigorous as in HA, but the degradation was more rapid than in HA. These results suggest that beta-CPP is a more ideal new bone graft substitute.