tricalcium phosphate
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CÍL: Kostní defekty jsou problematikou zejména traumatologie, ortopedie a onkologie. Tradiční metodou léčby je autospongioplastika, v popředí zájmu je dnes použití resorbovatelných materiálů s osteoindukčními vlastnostmi (trikalciumfosfát - ChronOS). Cílem předkládané studie je ověření použití samotného trikalciumfosfátu v léčbě velkého diafyzárního defektu na modelu miniaturního prasete. Pozitivní výsledek by mohl omezit nutnost provádění spongioplastiky a zjednodušit celý proces léčby. Získané výsledky budou také sloužit jako technologická východiska pro studium možnosti náhrady kostních defektů mezenchymovými kmenovými buňkami. MATERIÁL A METODIKA: Experimentální skupinu tvořilo 25 miniaturních prasat z certifikovaného chovu Ústavu živočišné fyziologie a genetiky Akademie věd. U 12 prasat byl použit k náhradě defektu Trikaciumfosfát a u 13 prasat autogenní spongiózní štěp. Do vytvořeného diafyzárního defektu byl vložen Trikalciufosfát či autoštěp a zafixován. V obou skupinách byla fixace provedena LCP dlahou a intramedulárně Kirschnerovým drátem. Po zhojení byla tato oblast histologicky zpracována a hodnocena stran tvorby nové kostní tkáně a přihojení k původní kosti v místě okrajů defektu. VÝSLEDKY: Z výsledků vyplývá, že ve skupině s použitím autoštěpů došlu k výraznější novotvorbě zralé kostní tkáně. Při hodnocení okrajů defektu stran přihojení k původní kosti byly výsledky u skupiny s autoštěpem výrazně lepší. ZÁVĚR: Očekávané osteoindukční vlastnosti samotného trikalciumfosfátu se u rozsáhlého defektu diafýzy stehenní kosti v provedeném experimentu nepotvrdily. Náhradu autospongioplastiky jinou neinvazivní metodou v léčbě velkých kostních defektů je třeba nadále experimentálně hledat. Východiskem může být použitá operační metodika a využití vhodného biologického nosiče poskytujícího mechanickou oporu v kombinaci s trikalciumfosfátem nebo mezenchymovými kmenovými buňkami.
AIM: Bone defects are, in particular, the problematics of traumatology, orthopedics and oncology. The traditional method of treatment is autospongioplastics, nowadays the use of absorbable materials with osteoinductive properties (tricalcium phosphate - ChronOS)1,2 is in the forefront. The aim of the submitted study is to verify the application of tricalcium phosphate itself as a treatment of a large diaphyseal bone defect in a model of a miniature pig. A positive result could reduce the necessity of bonegrafting and thus simplify the whole process of treatment. The results obtained will serve as technological starting points for further studies regarding the possibility of replacement of bone defects by mesenchymal stem cells. MATERIALS AND METHODS: The experimental group was made up of 25 miniature pigs from the certified breeding of the Institute of Animal Physiology and Genetics Academy of Sciences. In 12 pigs the tricalcium phosphate as a replacement of the defect was used and in 13 pigs autogennous cancellous graft was used. The tricalcium phosphate, or autograft, was applied and fixed into the diaphyseal bone defect, which was formed. In both groups the fixation was carried out by means of LCP and application of intramedullary Kirschner wire. After healing, this area was processed from the histological point of view and evaluated with respect to the new formation of bone tissue and engraftment to the original bone, in the area of the edges of the defect. RESULTS: The results demonstrate that in the group with the application of autografts, more distinctive new formation of the mature bone tissue occurred. While evaluating the edges of the defect with regard to the engraftment to the original bone, the results in the group with the application of autograft were distinctively better. CONCLUSION: In the experiment conducted, the expected osteoinductive properties of the tricalcium phosphate itself have not been confirmed for the extensive defect of the femoral diaphysis. It is necessary to go on searching for the replacement of autospongioplastics by another noninvasive method for the treatment of extensive bone defects, by means of conducting experiments. The starting point might be the applied surgery method and the use of an appropriate biological carrier that will provide a mechanical support in combination with the tricalcium phosphate or mesenchymal stem cells.
Due to unique osteogenic properties, tricalcium phosphate (TCP) has gained relevance in the field of bone repair. The development of novel and rapid sintering routes is of particular interest since TCP undergoes to high-temperature phase transitions and is widely employed in osteoconductive coatings on thermally-sensitive metal substrates. In the present work, TCP bioceramics was innovatively obtained by Ultrafast High-temperature Sintering (UHS). Ca-deficient hydroxyapatite nano-powder produced by mechanochemical synthesis of mussel shell-derived calcium carbonate was used to prepare the green samples by uniaxial pressing. These were introduced within a graphite felt which was rapidly heated by an electrical current flow, reaching heating rates exceeding 1200 °C min-1. Dense (> 93%) ceramics were manufactured in less than 3 min using currents between 25 and 30 A. Both β and α-TCP were detected in the sintered components with proportions depending on the applied current. Preliminary tests confirmed that the artifacts do not possess cytotoxic effects and possess mechanical properties similar to conventionally sintered materials. The overall results prove the applicability of UHS to bioceramics paving the way to new rapid processing routes for biomedical components.
PURPOSE: To compare the efficacy of 2 common materials in sinus augmentation surgery and to assess their contribution when enriched with autogenous bone. MATERIALS AND METHODS: The prospective human study was performed in 48 sinus grafting operations using beta-tricalcium phosphate or deproteinized bovine bone (pure or mixed with 10% to 20% autogenous bone) or autogenous bone. Biopsy specimens were taken after 9 months. Statistical evaluation was done with a 2-sample t test (P < .05). RESULTS: When autogenous bone was used, 49.2% +/- 3.1% of new bone was found, which is significantly higher than in all the other groups. A higher proportion (34.2% +/- 13.1%) of the new vital bone was found in the deproteinized bovine bone group, in comparison with the beta-tricalcium phosphate group (21.4% +/- 8.1%) and the beta-tricalcium phosphate composite graft group (24.0% +/- 6.6%; P < .05). No significant differences between single-component grafts and corresponding composite grafts were established. CONCLUSIONS: Sinus augmentation with the aforementioned augmentation materials is a well-accepted procedure. However, autogenous bone alone was the best material. More new bone was found using deproteinized bovine bone than beta-tricalcium phosphate. The addition of 10% to 20% autogenous bone to the bone substitute did not significantly influence the new bone formation.
- MeSH
- dospělí MeSH
- financování organizované MeSH
- fosforečnany vápenaté MeSH
- kostní náhrady MeSH
- lidé středního věku MeSH
- lidé MeSH
- minerály MeSH
- průřezové studie MeSH
- regenerace kostí MeSH
- senioři MeSH
- sinus maxillaris chirurgie MeSH
- skot MeSH
- stomatochirurgické předprotetické výkony metody MeSH
- transplantace kostí MeSH
- zvířata MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- skot MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- klinické zkoušky kontrolované MeSH
- srovnávací studie MeSH
The present work studies the microstructure and mechanical performance of tricalcium phosphate (TCP) based cermet toughened by iron particles. A novelty arises by the employment of spark plasma sintering for fabrication of the cermet. Results showed partial transformation of initial alpha TCP matrix to beta phase and the absence of oxidation of iron particles, as well as a lack of chemical reaction between TCP and iron components during sintering. The values of compressive and tensile strength of TCP/Fe cermet were 3.2 and 2.5 times, respectively, greater than those of monolithic TCP. Fracture analysis revealed the simultaneous action of crack-bridging and crack-deflection microstructural toughening mechanisms under compression. In contrast, under tension the reinforcing mechanism was only crack-bridging, being the reason for smaller increment of strength. Elastic properties of the cermet better matched values reported for human cortical bone. Thereby the new TCP/Fe cermet has potential for eventual use as a material for bone fractures fixation under load-bearing conditions.
Cíl práce: Cílem práce bylo zjištění poklesu hloubky parodontálních chobotů, jak hluboké choboty přetrvávají po tomto ošetření. Dalším účelem bylo dozvědět se, zda dochází k ústupu gingivy a v jakém stupni. Byla hodnocena i úroveň gingivodentálního spojení před ošetřením a po jednom roce. Metodika: Do studie bylo zařazeno 21 pacientů; všichni prošli iniciální fází, spolupracovali výborně, věk se pohyboval mezi 21 až 53 lety. Soubor tvořilo osm mužů a 13 žen. U 21 vyšetřených bylo do šetření zařazeno 39 zubů s hloubkou parodontálních chobotů ≥ 5 mm po iniciální terapii. Měřeny byly gingivální recesy před ošetřením a po ošetření. Zaznamenány byly hodnoty BOP. Na rtg snímcích byla resorpce kosti. Pacienti byli celkově zdraví, neužívali poslední tři měsíce antibiotika ani léky ovlivňující krevní srážlivost. Vyloučeny byly těhotné ženy. Zuby byly vitální nebo řádně endodonticky ošetřeny. Výsledky: Počet chobotů po chirurgickém výkonu poklesl ve všech měřeních. Největší stupeň ústupu gingivy byl vestibulárně. Největší pokles hloubky parodontálních chobotů byl meziálně a distálně (detaily viz tabulka).
Aim of study: The study was focused on the decrease of the depth of periodontal pockets and to obtain the information about depth of pockets after this type of treatment. Another result was to have information if there are recessions of soft tissues and the grade of recessions. Also the attachement level was evaluated before and one year after treatment. Method: 21 patients were includuded to the study, all of them passed through inicial phase, collaboration was on very good level. Age between 21–53 yers. Set of patients was composed by eight men and 13 women. For further treatment of 39 teeth with pocket depth ≥ 5 mm after inicial therapy was recomended GTR. Recessions were measured before and after treatment. Also were registered values of BOP. X-ray pictures confirmed bone resorption. All patients were generaly healthy, last three months no medication by antibiotics or anticoagulation drugs. No women were pregnant. Teeth were vital or correctly endodontic treated. Results: The study confirmed decrease of the number of teeth with pockets in all measurements. Conspicious decrease of pocket depth was registered on aproximal sides it means mesialy and distaly. We registered more noteceable recession on vestibular sides.
- Klíčová slova
- kalcium sulfát,
- MeSH
- endoseální implantace zubů * MeSH
- fosfáty terapeutické užití MeSH
- lidé MeSH
- orální hygiena MeSH
- parodontální chobot * diagnostické zobrazování chirurgie terapie MeSH
- parodontitida MeSH
- retrospektivní studie MeSH
- techniky odtažení gingivy MeSH
- transplantace kostí metody MeSH
- ústup dásní terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
This report describes the histological characteristics of large human bone defects that were implanted with β-tricalcium phosphate (β-TCP). Samples were obtained longer after the primary operation than in the earlier studies. We assessed a total of nine biopsies taken 33-208 weeks after implantation. The tissue sections were stained with hematoxylin-eosin for general observation, with Gomori stain to visualize the reticulin fibers, and with an antibody against tartrate-resistant alkaline phosphatase (TRAP) to characterize the cells. Ongoing bone remodeling was observed even 208 weeks after implantation as determined by the presence of osteoclasts and active osteoblasts and new woven and lamellar bone. We observed multinuclear giant cells phagocytosing the biomaterial and the attachment of osteoclasts to the β-TCP. The osteoclasts showed intense TRAP positivity, while the giant cells showed variable TRAP positivity. There was a zonal pattern in the original defects: The central regions showed granules and fibrous septa, while peripheral areas showed a layer of new bone formation. These data demonstrate ongoing bone remodeling long after implantation in the peripheral regions of the original defects as well as fibrous changes in the central regions and phagocytosis of biomaterial by multinuclear giant cells.
- MeSH
- biopsie MeSH
- dítě MeSH
- dospělí MeSH
- fosforečnany vápenaté terapeutické užití MeSH
- kosti a kostní tkáň patologie MeSH
- kostní náhrady terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nemoci kostí patologie terapie MeSH
- osteoblasty patologie MeSH
- osteoklasty patologie MeSH
- remodelace kosti MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Úvod: Studie je zaměřena na zhodnocení klinických výsledků kombinovaného preparátu obsahujícího beta-trikalcium fosfát a kalcium sulfát pro léčbu parodontálních vnitrokostních defektů. Kombinace těchto materiálů dává předpoklad pro vyšší efekt řízené tkáňové regenerace při její aplikaci právě díky vlastnostem této kombinace. Materiál a metodika: V práci jsou hodnotící výsledky léčby u 47 zubů s intrakostními defekty celkem u 26 pacientů. U všech byl použit preparát Fortoss® Vital (Biocomposites, Stafordshire, Velká Británie). Byly hodnoceny klinické parametry, což zahrnuje zjišťování změn hloubky parodontálních chobotů, úroveň gingivodentálního spojení, tedy pokles či nárůst (clinical attachement level) gingiválních recesů na začátku ošetření a po dvou letech od ošetření. Výsledky a závěr: Průměrnou změnou po dvou letech od ošetření byla redukce hloubky parodontálních chobotů o 2,07 ± 1,14 mm (p = 0,000), nárůstek u gingivo-dentálního spojení o 1,93 mm ± 1,36 mm (p = 0,000) a změna gingiválních recesů o 0,14 ± 0,73 mm (p = 0,571). Výsledky této studie ukázaly, že léčba kombinací beta-trikalcium fosfátem a kalcium sulfátem signifikantně zlepšuje pozitivní klinické výsledky u intraoseálních defektů i po dvou letech po chirurgickém ošetření.
Background: The study was designed to evaluate the clinical results of a composite material beta-tricalcium phosphate in combination with calcium sulphate in the treatment of periodontal intrabony defects. The combination of these materials is believed to aid in guieded tissue regeneration owing to their properties. Material and methods: A total of 47 teeth with intrabony defectsin in 26 periodontitis patiens were treated with Forthoss® Vital (Biocomposites, Staffordshiere, UK). Clinical parameters were evaluated included changes in probing depth, clinical attachement levels loss and gingival recession at the baseline and two years postoperatively. Results and conslusion: The mean in differences in mesurements between the baseline and two years postoperatively were a reduction of 2.07 ± 0.14 mm (p = 0.000) in case of probing depth and gain of 1.93 ± 1.36 mm (p = 0.000) in clinical attachement level; but an increase of 0.14 ± 0.73 mm (p = 0.571) in gingival recession. The study results showing that the treatment with the combination of beta-tricalcium phosphate and calcium phosphate and calcium sulphate led to a significantly favorable clinical improvement in periodontal intrabony defects two years after the surgery.
- Klíčová slova
- retrospektivní průkaz, intraoseální defekt, beta-trikalcium fosfát,
- MeSH
- biokompatibilní materiály terapeutické užití MeSH
- dospělí MeSH
- fosforečnany vápenaté * terapeutické užití MeSH
- kostní náhrady klasifikace terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- parodontální chobot terapie MeSH
- parodontitida chirurgie terapie MeSH
- regenerace kostí MeSH
- řízená tkáňová regenerace parodontu * MeSH
- síran vápenatý * terapeutické užití MeSH
- stomatochirurgické výkony metody MeSH
- transplantace kostí MeSH
- výsledek terapie MeSH
- zubní materiály * klasifikace terapeutické užití MeSH
- zuby patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
In this work alpha tricalcium phosphate (α-TCP)/iron (Fe) composites were developed as a new family of biodegradable, load-bearing and cytocompatible materials. The composites with composition from pure ceramic to pure metallic samples were consolidated by pulsed electric current assisted sintering to minimise processing time and temperature while improving their mechanical performance. The mechanical strength of the composites was increased and controlled with the Fe content, passing from brittle to ductile failure. In particular, the addition of 25 vol% of Fe produced a ceramic matrix composite with elastic modulus much closer to cortical bone than that of titanium or biodegradable magnesium alloys and specific compressive strength above that of stainless steel, chromium-cobalt alloys and pure titanium, currently used in clinic for internal fracture fixation. All the composites studied exhibited higher degradation rate than their individual components, presenting values around 200 μm/year, but also their compressive strength did not show a significant reduction in the period required for bone fracture consolidation. Composites showed preferential degradation of α-TCP areas rather than β-TCP areas, suggesting that α-TCP can produce composites with higher degradation rate. The composites were cytocompatible both in indirect and direct contact with bone cells. Osteoblast-like cells attached and spread on the surface of the composites, presenting proliferation rate similar to cells on tissue culture-grade polystyrene and they showed alkaline phosphatase activity. Therefore, this new family of composites is a potential alternative to produce implants for temporal reduction of bone fractures. STATEMENT OF SIGNIFICANCE: Biodegradable alpha-tricalcium phosphate/iron (α-TCP/Fe) composites are promising candidates for the fabrication of temporal osteosynthesis devices. Similar to biodegradable metals, these composites can avoid implant removal after bone fracture healing, particularly in young patients. In this work, α-TCP/Fe composites are studied for the first time in a wide range of compositions, showing not only higher degradation rate in vitro than pure components, but also good cytocompatibility and mechanical properties controllable with the Fe content. Ceramic matrix composites show high specific strength and low elastic modulus, thus better fulfilling the requirements for bone fractures fixation. A significant advance over previous works on the topic is the use of pulsed electric current assisted sintering together with α-TCP, convenient to improve the mechanical performance and degradation rate, respectively.
- MeSH
- fosforečnany vápenaté farmakologie MeSH
- fraktury kostí farmakoterapie metabolismus patologie MeSH
- keramika farmakologie MeSH
- kostní náhrady farmakologie MeSH
- lidé MeSH
- modul pružnosti MeSH
- nádorové buněčné linie MeSH
- osteoblasty metabolismus patologie MeSH
- testování materiálů MeSH
- železo farmakologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
To test the hypothesis that the application of tricalcium phosphate (TCP) mixed with autologous bone marrow can achieve better and faster healing of benign bone lesions than the application of tricalcium phosphate granules alone. MATERIAL AND METHODS: The prospective study included two groups, each consisting of 10 patients, treated for benign cystic bone lesions at the Department of Paediatric Surgery, Orthopaedics and Trauma Surgery from July 1, 2008 to June 30, 2010. The bone cysts involved non-ossifying fibroma, enchodroma, fibrous dysplasia, aneurysmal bone cyst and juvenile bone cyst. One group was treated using ChronOS(TM) Beta-Tricalcium Phosphate (Synthes GmbH, Switzerland) granules mixed with autologous bone marrow harvested during surgery (BM group). The other (CH group) received treatment with ChronOS granules alone. Relevant clinical data were obtained from all 20 patients treated for one of the bone cyst forms mentioned above. The patients were followed up till the end of 2010. RESULTS: TCP application was a one-step procedure in both groups. In the BM group, bone regeneration ad integrum (Neer 1) was achieved, with only an occasional very small residue of the cyst seen on radiographs (Neer 2). None of the patients reported any problems, not even at 6 months after surgery. In the CH group, two patients required further surgical treatment because of insufficient bone healing (Neer 3) and two other patients reported pain persisting at the site of the lesion at 6 months post-operatively. In these patients TCP was used to fill a defect after excochleation of an aneurysmal bone cyst or fibrous dysplasia. The rest of the patients showed satisfactory healing. DISCUSSION: The main objective of the use of synthetic biocompatible materials in surgical treatment of benign bone cysts requiring filling of the lesion is to reduce the post-operative stress of paediatric patients as much as possible. Although our first results were not statistically significant to give unambiguous support to our hypothesis that lesions would heal better with the use of synthetic tricalcium phosphate mixed with autologous bone marrow, there is plenty of evidence that further development of cell technologies will result in a more exact definition of bone substitute materials in both their components, i.e., well-defined cells and non-biological scaffolds close in structure to inorganic compounds of bone, i.e., biodegradable osteoinductive materials. CONCLUSIONS: The patients with benign bone lesions treated by TCP mixed with autologous bone marrow showed neither recurrent disease nor complications. The group treated with TCP alone had recurrent lesions in two and persisting pain also in two patients. Other complications were not recorded.
- MeSH
- autologní transplantace MeSH
- dítě MeSH
- financování organizované MeSH
- fosfáty terapeutické užití MeSH
- interpretace statistických dat MeSH
- kostní cysty chirurgie MeSH
- kostní náhrady terapeutické užití MeSH
- lidé MeSH
- prospektivní studie MeSH
- statistika jako téma MeSH
- transplantace kostní dřeně MeSH
- výsledek terapie MeSH
- výsledky a postupy - zhodnocení (zdravotní péče) MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
