Efficacy and Safety of Antibiotic Impregnated Microporous Nanohydroxyapatite Beads for Chronic Osteomyelitis Treatment: A Multicenter, Open-Label, Prospective Cohort Study.

Chronic osteomyelitis is still a serious health problem that causes disabling conditions and has an impact on the quality of life. The objective of this study was to determine the clinical efficacy and safety of localized antibiotics delivery via impregnated microporous nanohydroxyapatite (nHA-ATB) beads for chronic osteomyelitis treatment. A total of 62 patients were enrolled in this study. After radical surgical debridement, the bone defect was filled with three types of antibiotics (vancomycin or gentamicin or fosfomycin) impregnated HA beads. The follow-up period was 48 weeks. It was found that the success rate was approximately 98% with a re-infection in only one patient. Quality of life of all patients after treatment improved significantly over time. Systemic exposure to vancomycin and gentamicin after beads implantation was limited and high local antibiotics concentrations were found in wound drainage fluid at 24, 48 and 72 h. Blood biochemistry measurements did not show any nephrotoxic or hepatotoxic effects. 20 adverse events were reported, but 90% of the events were resolved without having to remove the beads and the patients recovered. Satisfactory outcomes were observed in terms of success rate, quality of life and adverse effect. nHA-ATB beads impregnated by vancomycin or gentamicin or fosfomycin could potentially be employed as an alternative product of choice for localized antibiotics delivery in chronic osteomyelitis treatment.

Physical Properties of Glass Ionomer Cement Containing Pre-Reacted Spherical Glass Fillers.

The aim of this study was to assess the effect of different commercial liquid phases (Ketac, Riva, and Fuji IX) and the use of spherical pre-reacted glass (SPG) fillers on cement maturation, fluoride release, compressive (CS) and biaxial flexural strength (BFS) of experimental glass ionomer cements (GICs). The experimental GICs (Ketac_M, Riva_M, FujiIX_M) were prepared by mixing SPG fillers with commercial liquid phases using the powder to liquid mass ratio of 2.5:1. FTIR-ATR was used to assess the maturation of GICs. Diffusion coefficient of fluoride (DF) and cumulative fluoride release (CF) in deionized water was determined using the fluoride ion specific electrode (n=3). CS and BFS at 24 h were also tested (n=6). Commercial GICs were used as comparisons. Riva and Riva_M exhibited rapid polyacrylate salt formation. The highest DF and CF were observed with Riva_M (1.65x10-9 cm2/s) and Riva (77 ppm) respectively. Using SPG fillers enhanced DF of GICs on average from ~2.5x10-9 cm2/s to ~3.0x10-9 cm2/s but reduced CF of the materials on average from ~51 ppm to ~42 ppm. The CS and BFS of Ketac_M (144 and 22 MPa) and Fuji IX_M (123 and 30 MPa) were comparable to commercial materials. Using SPG with Riva significantly reduced CS and BFS from 123 MPa to 55 MPa and 42 MPa to 28 MPa respectively. The use of SPG fillers enhanced DF but reduced CF of GICs. Using SPG with Ketac or Fuji IX liquids provided comparable strength to the commercial materials.

Physical properties of glass ionomer cement containing pre-reacted spherical glass fillers

Abstract The aim of this study was to assess the effect of different commercial liquid phases (Ketac, Riva, and Fuji IX) and the use of spherical pre-reacted glass (SPG) fillers on cement maturation, fluoride release, compressive (CS) and biaxial flexural strength (BFS) of experimental glass ionomer cements (GICs). The experimental GICs (Ketac_M, Riva_M, FujiIX_M) were prepared by mixing SPG fillers with commercial liquid phases using the powder to liquid mass ratio of 2.5:1. FTIR-ATR was used to assess the maturation of GICs. Diffusion coefficient of fluoride (DF) and cumulative fluoride release (CF) in deionized water was determined using the fluoride ion specific electrode (n=3). CS and BFS at 24 h were also tested (n=6). Commercial GICs were used as comparisons. Riva and Riva_M exhibited rapid polyacrylate salt formation. The highest DF and CF were observed with Riva_M (1.65x10-9 cm2/s) and Riva (77 ppm) respectively. Using SPG fillers enhanced DF of GICs on average from ~2.5x10-9 cm2/s to ~3.0x10-9 cm2/s but reduced CF of the materials on average from ~51 ppm to ~42 ppm. The CS and BFS of Ketac_M (144 and 22 MPa) and Fuji IX_M (123 and 30 MPa) were comparable to commercial materials. Using SPG with Riva significantly reduced CS and BFS from 123 MPa to 55 MPa and 42 MPa to 28 MPa respectively. The use of SPG fillers enhanced DF but reduced CF of GICs. Using SPG with Ketac or Fuji IX liquids provided comparable strength to the commercial materials.

Resumo O objetivo deste estudo foi avaliar o efeito de diferentes fases líquidas comerciais (Ketac, Riva e Fuji IX) e o uso de partículas esféricas de vidro pré-reagido (SPG) na maturação do cimento, liberação de flúor, força de compressão (CS) e resistência biaxial à flexão (BFS) de cimentos de ionômero de vidro (GICs) experimentais. Os GICs experimentais (Ketac_M, Riva_M, FujiIX_M) foram preparados pela mistura de partículas SPG com fases líquidas comerciais usando a proporção de pó para massa líquida de 2,5: 1. O FTIR-ATR foi usado para avaliar a maturação dos GICs. O coeficiente de difusão do flúor (DF) e a liberação cumulativa de flúor (CF) em água deionizada foram determinados usando o eletrodo específico do íon fluoreto (n = 3). CS e BFS em 24 h também foram testados (n = 6). GICs comerciais foram usados como comparações. Riva e Riva_M exibiram rápida formação de sal de poliacrilato. Os maiores DF e CF foram observados com Riva_M (1,65x10-9 cm2/s) e Riva (77 ppm), respectivamente. O uso de partículas SPG melhorou o DF de GICs em média de ~ 2,5x10-9 cm2/s a ~ 3,0x10-9 cm2/s, mas reduziu o CF dos materiais em média de ~ 51 ppm a ~ 42 ppm. O CS e BFS de Ketac_M (144 e 22 MPa) e Fuji IX_M (123 e 30 MPa) foram comparáveis aos materiais comerciais. Usar SPG com Riva reduziu significativamente CS e BFS de 123 MPa para 55 MPa e 42 MPa para 28 MPa, respectivamente. O uso de SPG partículas melhorou o DF, mas reduziu o CF dos GICs. O uso de partículas SPG com líquidos Ketac ou Fuji IX proporcionou resistência comparável aos materiais comerciais.

Evaluation of tissue ingrowth and reaction of a porous polyethylene block as an onlay bone graft in rabbit posterior mandible.

PURPOSE: A new form of porous polyethylene, characterized by higher porosity and pore interconnectivity, was developed for use as a tissue-integrated implant. This study evaluated the effectiveness of porous polyethylene blocks used as an onlay bone graft in rabbit mandible in terms of tissue reaction, bone ingrowth, fibrovascularization, and graft-bone interfacial integrity. METHODS: Twelve New Zealand white rabbits were randomized into 3 treatment groups according to the study period (4, 12, or 24 weeks). Cylindrical specimens measuring 5 mm in diameter and 4.5 mm in thickness were placed directly on the body of the mandible without bone bed decortication, fixed in place with a titanium screw, and covered with a collagen membrane. Histologic and histomorphometric analyses were done using hematoxylin and eosin-stained bone slices. Interfacial shear strength was tested to quantify graft-bone interfacial integrity. RESULTS: The porous polyethylene graft was observed to integrate with the mandibular bone and exhibited tissue-bridge connections. At all postoperative time points, it was noted that the host tissues had grown deep into the pores of the porous polyethylene in the direction from the interface to the center of the graft. Both fibrovascular tissue and bone were found within the pores, but most bone ingrowth was observed at the graft-mandibular bone interface. Bone ingrowth depth and interfacial shear strength were in the range of 2.76-3.89 mm and 1.11-1.43 MPa, respectively. No significant differences among post-implantation time points were found for tissue ingrowth percentage and interfacial shear strength (P>0.05). CONCLUSIONS: Within the limits of the study, the present study revealed that the new porous polyethylene did not provoke any adverse systemic reactions. The material promoted fibrovascularization and displayed osteoconductive and osteogenic properties within and outside the contact interface. Stable interfacial integration between the graft and bone also took place.

The effect of powder to liquid ratio on physical properties and fluoride release of glass ionomer cements containing pre-reacted spherical glass fillers.

The aim was to assess the effect of powder to liquid ratio (PLR) on setting time, fluoride release, and compressive strength of conventional glass ionomer cements (GICs) containing pre-reacted spherical glass fillers (SPG). GICs were prepared by mixing SPG with Fuji IX Universal liquid using PLR of 1:1, 1.5:1, 2:1, 2.5:1, 3:1. Setting time decreased from 221 to 51 s upon rising PLR. Increasing PLR decreased cumulative fluoride release (33 to 13 ppm). Diffusion coefficient of fluoride of experimental GICs (1.6-1.8×10-8 cm2/s) was comparable with that of Fuji IX Universal (1.6×10-8 cm2/s). Compressive strength of PLR 2:1 to 3:1 (93-140 MPa) were comparable with that of Fuji IX Universal (124 MPa). These results demonstrated that rising powder ratio reduced setting time, fluoride release, and compressive strength of GICs. However, the setting time and strength experimental GICs with PLR greater than 2:1 were in the acceptable range of the ISO standard.

Properties of poly(lactic acid)/hydroxyapatite composite through the use of epoxy functional compatibilizers for biomedical application.

A composite of 70/30 poly(lactic acid)/hydroxyapatite was systematically prepared using various amounts of glycidyl methacrylate as reactive compatibilizer or Joncryl ADR®-4368 containing nine glycidyl methacrylate functions as a chain extension/branching agent to improve the mechanical and biological properties for suitable usage as internal bone fixation devices. The effect of glycidyl methacrylate/Joncryl on mechanical properties of poly(lactic acid)/hydroxyapatite was investigated through flexural strength. Cell proliferation and differentiation of osteoblast-like MC3T3-E1 cells cultured on the composite samples were determined by Alamar Blue assay and alkaline phosphatase expression, respectively. Result shows that flexural strength tends to decrease, as glycidyl methacrylate content increases except for 1 wt.% glycidyl methacrylate. With an addition of dicumyl peroxide, the flexural strength shows an improvement than that of without dicumyl peroxide probably due to the chemical bonding of the hydroxyapatite and poly(lactic acid) as revealed by FTIR and NMR, whereas the composite with 5 wt.% Joncryl shows the best result, as the flexural strength increases getting close to pure poly(lactic acid). The significant morphology change could be seen in composite with Joncryl where the uniform agglomeration of hydroxyapatite particles oriented in poly(lactic acid) matrix. Addition of the epoxy functional compatibilizers at suitable percentages could also have benefits to cellular attachment, proliferation, differentiation and mineralization. So that, this poly(lactic acid)/hydroxyapatite composite could be a promising material to be used as internal bone fixation devices such as screws, pins and plates.