In vitro and in vivo analyses of the biocompatibility of sintered TCP-HA composite screws

다국어 초록 (Multilingual Abstract)

Biphasic calcium phosphate (BCP), which is a β-tricalcium phosphate (TCP) and hydroxyapatite (HA) composite, is used mainly as a bone graft material. However, it has recently been used for orthopedic, oral, and maxillofacial surgeries. The use of BCP to produce an absorbable screw and plate to reconstruct fractures has been suggested. Nevertheless, further research on using BCP in the surgical field will be needed. In particular, studies on the physical properties of BCP and in vivo analysis are essential. In this study, TCP and HA were mixed at a ratio of 7:3 and heat-treated to form BCP. Scanning electron microscopy, energy-dispersive X-ray spectroscopy, X-ray diffraction, and an MTT assay were conducted to evaluate the surface characteristics and physical and biological properties of each sample. In addition, BCP was used to produce a screw to be implanted into the mandible of beagles. An analysis of the physical properties of BCP confirmed the intermediate properties between TCP and HA. The cell viability was better with BCP than TCP, and significant differences were observed on days 1 and 3. Histological analysis at eight weeks after inserting the BCP screw into the mandible of beagles revealed osseointegration between the BCP screw and bone. The results showed that BCP had better mechanical properties than TCP and excellent biocompatibility, highlighting its potential clinical use. In addition, according to its processing, BCP may be used to produce screws and plates for fracture repair or as membranes and space-modeling tents for guided bone regeneration.

참고문헌 (Reference)

1 Cory AH, "Use of an aqueous soluble tetrazolium/formazan assay for cell growth assays in culture" 3 : 207-212, 1991

2 Erkmen E, "Three-dimensional finite element analysis used to compare methods of fixation after sagittal split ramus osteotomy : setback surgeryposterior loading" 43 : 97-104, 2005

3 Shin YS, "The effects of ErhBMP-2-/EGCG-coated BCP bone substitute on dehiscence around dental implants in dogs" 20 : 281-287, 2014

4 Kim JH, "The effect of nanotubular titanium surfaces on osteoblast differentiation" 10 : 3581-3585, 2010

5 Wang PE, "Sintering behaviour and mechanical properties of hydroxyapatite and dicalcium phosphate" 4 : 150-158, 1993

6 손병진 ; 황민경 ; 김성태 ; 김형일 ; 구영, "Ridge preservation using basic fibroblast growth factor-2 and collagenated biphasic calcium phosphate in beagle dogs" 대한치주과학회 47 (47): 381-387, 2017

7 Fedorowicz Z, "Resorbable versus titanium plates for orthognathic surgery" (2) : CD006204-, 2007

8 Bohner M, "Resorbable biomaterials as bone graft substitutes" 13 : 24-30, 2010

9 Lu J, "Relationship between bioceramics sintering and micro-particles-induced cellular damages" 15 : 361-365, 2004

10 Hing KA, "Quantification of bone ingrowth within bone-derived porous hydroxyapatite implants of varying density" 10 : 663-670, 1999

11 Higashi S, "Polymer-hydroxyapatite composites for biodegradable bone fillers" 7 : 183-187, 1986

12 Takahashi Y, "Osteogenic differentiation of mesenchymal stem cells in biodegradable sponges composed of gelatin and beta-tricalcium phosphate" 26 : 3587-3596, 2005

13 Elgendy H, "Osteoblastlike cell(MC3T3-E1)proliferation on bioerodible polymers : an approach towards the development of a bonebioerodible polymer composite material" 14 : 263-269, 1993

14 Le Guehennec L, "Osteoblastic cell behaviour on different titanium implant surfaces" 4 : 535-543, 2008

15 Ray MS, "Metallic fragments on the surface of miniplates and screws before insertion" 37 : 14-18, 1999

16 Moussa M, "Medium-term function of a 3D printed TCP/HA structure as a new osteoconductive scaffold for vertical bone augmentation: a simulation by BMP-2 activation" 8 : 2174-2190, 2015

17 Böstman O, "Intense granulomatous inflammatory lesions associated with absorbable internal fixation devices made of polyglycolide in ankle fractures" 278 : 193-199, 1992

18 Strobel LA, "Induction of bone formation in biphasic calcium phosphate scaffolds by bone morphogenetic protein-2 and primary osteoblasts" 8 : 176-185, 2014

19 Hirvensalo E, "Fracture fixation with biodegradable rods. Forty-one cases of severe ankle fractures" 60 : 601-606, 1989

20 Böstman O, "Foreignbody reactions to fracture fixation implants of biodegradable synthetic polymers" 72 : 592-596, 1990

21 Lee JH, "Fabrication and evaluation of porous beta-tricalcium phosphate/hydroxyapatite(60/40)composite as a bone graft extender using rat calvarial bone defect model" 2013 : 481789-, 2013

22 Yaszemski MJ, "Evolution of bone transplantation : molecular, cellular and tissue strategies to engineer human bone" 17 : 175-185, 1996

23 Kurashina K, "Ectopic osteogenesis with biphasic ceramics of hydroxyapatite and tricalcium phosphate in rabbits" 23 : 407-412, 2002

24 van Bakelen NB, "Decisionmaking considerations in application of biodegradable fixation systems in maxillofacial surgery--a retrospective cohort study" 42 : 417-422, 2014

25 Ignjatović N, "Cytotoxicity and fibroblast properties during in vitro test of biphasic calcium phosphate/poly-dl-lactide-co-glycolide biocomposites and different phosphate materials" 69 : 976-982, 2006

26 Eun-Ung Lee ; Dong-Ju Kim ; 임현창 ; 이중석 ; 정의원 ; 최성호, "Comparative evaluation of biphasic calcium phosphate and biphasic calcium phosphate collagen composite on osteoconductive potency in rabbit calvarial defect" 한국생체재료학회 19 (19): 50-56, 2015

27 Claes L, "Clinical implant materials: proceedings of the Eighth European Conference on Biomaterials" Elsevier 260-, 1990

28 Claes LE, "Clinical Materials" Technik + Kommunikation VerlagsGmbH 41-46, 1992

29 Durucan C, "Calcium-deficient hydroxyapatite-PLGA composites : mechanical and microstructural investigation" 51 : 726-734, 2000

30 Ginebra MP, "Calcium phosphate cements as bone drug delivery systems : a review" 113 : 102-110, 2006

31 Bohner M, "Calcium orthophosphates in medicine: from ceramics to calcium phosphate cements" 31 (31): 37-47, 2000

32 Kim JW, "Bone formation of block and particulated biphasic calcium phosphate lyophilized with Escherichia coliderived recombinant human bone morphogenetic protein 2 in rat calvarial defects" 112 : 298-306, 2011

33 Viljanen J, "Bone changes after experimental osteotomies fixed with absorbable self-reinforced poly-L-lactide screws or metallic screws studied by plain radiographs, quantitative computed tomography and magnetic resonance imaging" 16 : 1353-1358, 1995

34 Daculsi G, "Biphasic calcium phosphate concept applied to artificial bone, implant coating and injectable bone substitute" 19 : 1473-1478, 1998

35 Haers PE, "Biodegradable polylactide plates and screws in orthognathic surgery : technical note" 26 : 87-91, 1998

36 Böstman O, "Biodegradable internal fixation for malleolar fractures. A prospective randomised trial" 69 : 615-619, 1987

37 Frøkjaer J, "Biodegradable fixation of ankle fractures. Complications in a prospective study of 25 cases" 63 : 434-436, 1992

38 Hughes TB, "Bioabsorbable implants in the treatment of hand fractures : an update" 445 : 169-174, 2006

39 Waris E, "Bioabsorbable fixation devices in trauma and bone surgery : current clinical standing" 1 : 229-240, 2004

40 Cesar R, "Axial compressive strength of human vertebrae trabecular bones classified as normal, osteopenic and osteoporotic by quantitative ultrasonometry of calcaneus" 33 : 91-96, 2017

41 Kellman R, "Atlas of craniomaxillofacial fixation" Raven Press 283-312, 1995

42 Ryu HS, "An improvement in sintering property of beta-tricalcium phosphate by addition of calcium pyrophosphate" 23 : 909-914, 2002

43 Buijs GJ, "A randomized clinical trial of biodegradable and titanium fixation systems in maxillofacial surgery" 91 : 299-304, 2012

44 Damien E, "A preliminary study on the enhancement of the osteointegration of a novel synthetic hydroxyapatite scaffold in vivo" 66 : 241-246, 2003

45 Arinzeh TL, "A comparative study of biphasic calcium phosphate ceramics for human mesenchymal stem-cell-induced bone formation" 26 : 3631-3638, 2005