Multifunctional poly(ß-amino ester) hydrogel microparticles in periodontal in situ forming drug delivery systems.

In situ forming implants (ISIs) formed from poly(lactic-co-glycolic acid) (PLGA) have been commercialized for local drug delivery to treat periodontitis, but drug release from these bulk materials is typically subject to an initial burst. In addition, PLGA has inferior material properties for the dynamic mechanical environment of gingival tissue. In this work, poly(ß-amino ester) (PBAE) hydrogel microparticles were incorporated into a PLGA matrix to provide several new functions: mechanical support, porosity, space-filling, and controlled co-delivery of antimicrobial and osteogenic drugs. First, the effects of PBAE microparticles on ISI architecture and material properties throughout degradation were investigated. Second, the influence of PBAE microparticles on drug release kinetics was quantified. Over a 15 d period, ISIs containing PBAE microparticles possessed greater porosity, ranging from 42-80%, compared to controls, which ranged from 24-54% (p < 0.001), and these ISIs also developed significantly greater accessible volume to simulated cell-sized spheres after 5 d or more of degradation (p < 0.001). PBAE-containing ISIs possessed a more uniform microarchitecture, which preserved mechanical resilience after cyclical loading (p < 0.001), and the materials swelled to fill the injected space, which significantly increased interfacial strength in an artificial periodontal pocket (p < 0.0001). PBAE microparticles eliminated the burst of freely-mixed simvastatin compared to 36% burst from controls (p < 0.0001), and high-dose doxycycline release was prolonged from 2 d to 7 d by pre-loading drug into the microparticles. PBAE-containing PLGA ISIs are more effective space-filling scaffolds and offer improved release kinetics compared to existing ISIs used to treat periodontitis.

Doxycycline administration improves fascial interface in hernia repair.

BACKGROUND: Despite improvements in ventral hernia repair techniques, their recurrence rates are unacceptably high. Increased levels of matrix metalloproteinases (MMPs) and reduced collagen-1 to -3 ratios are implicated in incisional hernia formation. We have recently shown doxycycline treatment for 4 wk after hernia repair reduced MMP levels, significantly increased collagen-1 to -3 ratios, and increased tensile strength of repaired interface fascia. However, this increase was not statistically significant. In this study, we extended treatment duration to determine whether this would impact the tensile strength of the repaired interface fascia. MATERIALS AND METHODS: Thirty-two male Sprague-Dawley rats underwent incision hernia creation and subsequent repair with polypropylene mesh. The animals received either saline (n = 16) or doxycycline (n = 16) beginning from 1 day before hernia repair until the end of survival time of 6 wk (n = 16) or 12 wk (n = 16). Tissue samples were investigated for MMPs and collagen subtypes using Western blot procedures, and tensiometric analysis was performed. RESULTS: At both 6 and 12 wk after hernia repair, the tensiometric strength of doxycycline-treated mesh to fascia interface (MFI) tissue showed a statistically significant increase when compared with untreated control MFI. In both groups, collagen-1, -2, and -3 ratios were remarkably increased in doxycycline-treated MFI. At 6 wk, the doxycycline-treated MFI group showed a significant decrease in MMP-2, an increase in MMP-3, and no change in MMP-9. At 12 wk, MMP-9 showed a remarkable reduction, whereas MMP-2 and -3 protein levels increased in the doxycycline-treated MFI group. CONCLUSIONS: Doxycycline administration results in significantly improved strength of repaired fascial interface tissue along with a remarkable increase in collagen-1, -2, and -3 ratios.

Novel calcium sulfate space-making devices for bone regeneration: a pilot study.

The feasibility of using preformed calcium sulfate (CS) space-making devices (SMDs) for bone regeneration was explored using a rabbit calvarial model. Twenty-four CS devices were fabricated. Twelve of these were SMDs, which consisted of a domed head that served as the actual space-maker, and a stalk or "tail" portion used to affix the device to the bone. A second set of control devices (CDs) was fabricated that consisted of only the tail portion. CDs were made of medical-grade CS, as were 9 of the SMDs. Six of the CS SMDs were loaded with high or low concentrations of simvastatin. The remaining 3 SMDs were made of a CS/bioactive glass composite. One SMD and 1 CD were implanted bilaterally in the parietal bones of 12 New Zealand White rabbits, which were euthanized 8 weeks following surgery. All implants were well tolerated. In all animals, the side receiving the SMD exhibited greater thickness than did the control sites. The addition of simvastatin resulted in a statistically significant difference in calvarial thickness. The CS/bioactive glass composite also yielded encouraging results. The CS resorbable SMDs are worthy of further investigation.

Calcium sulfate: Properties and clinical applications.

Calcium sulfate (CS) has enjoyed a longer history of clinical use than most currently available biomaterials. It is well-tolerated when used to fill bone defects and undergoes rapid and complete resorption without eliciting a significant inflammatory response. The raw material from which it is made is relatively inexpensive and abundant. In addition, CS can be used as a vehicle to deliver antibiotics, pharmacologic agents, and growth factors. It has found wide use in orthopedics and dentistry, and has been used in a variety of clinical applications, including the periodontal defect repair, the treatment of osteomyelitis, sinus augmentation, and as an adjunct to dental implant placement. Despite these advantages, the material has not enjoyed the popularity of many other regenerative materials, although there has been a recent resurgence of interest in the material. This review examines the properties and clinical applications of CS, with an emphasis on dental applications of the material. Limitations of the material are discussed as well as suggestions for future research.

Calcium sulfate: a review.

Calcium sulfate has a long history of use in medicine and dentistry. It exists in two forms (alpha and beta), which differ greatly in physical properties. It has been used in bone regeneration as a graft material and graft binder/extender and as a barrier in guided tissue regeneration. It is an unusually biocompatible material and is completely resorbed following implantation. It does not evoke a significant host response and creates a calcium-rich milieu in the area of implantation. These calcium ions may provide some stimulation to osteoblasts, which may account for some of the positive results reported with the material. Calcium sulfate can be used as a delivery vehicle for growth factors and antibiotics, although this application has not been thoroughly exploited in the clinical setting. It has been shown that tissue will often migrate over calcium sulfate if primary closure cannot be obtained, which provides further evidence of its biocompatibility. The raw material from which calcium sulfate is made is relatively inexpensive and abundant. Despite these advantages, calcium sulfate has never attracted the same degree of research interest as have other biomaterials. Recently, however, it has enjoyed a resurgence of sorts in the areas of periodontology, sinus augmentation, and orthopedic surgery. Future research must be directed toward improving handling characteristics and strength, while preserving the biocompatibility of the material.

A study of the antiresorptive activity of salmon calcitonin microspheres using cultured osteoclastic cells.

The purpose of this study was to evaluate salmon calcitonin (sCT) microspheres in vitro for their antiresorptive activity using cultured osteoclastic cells. The antiresorptive activity of sCT-loaded microspheres, prepared from a low molecular weight hydrophilic poly (lactide-co-glycolide) polymer (PLGA), was studied using bone marrow culture cells harvested from juvenile rats and cultured on slices of devitalized bone for up to 4 weeks. The resorptive activity of osteoclastic cells was quantified in terms of number and type of resorption pits and total area of resorption. Microspheres containing 5.1% sCT released 70% peptide in 2 weeks and 88% in 4 weeks. All sCT treatments inhibited total resorptive activity. A dose-dependent decrease in resorption was observed with sCT microspheres at 2 weeks. The high dose (10 mg of microspheres) produced a 99.5% decrease in resorption at 3 weeks, while the low dose (1 mg) produced an 80% reduction. Exposure of cultures to soluble sCT and sCT-loaded microspheres caused a decrease in the number of large pits, which were the predominant type formed in control cultures. Thus, this system could serve as an in vitro method to evaluate the antiresorptive effect of PLGA-sCT microspheres.