Improving material properties of a poloxamer P407 hydrogel-based hydroxyapatite bone substitute material by adding silica-A comparative in vivo study.

The structure and handling properties of a P407 hydrogel-based bone substitute material (BSM) might be affected by different poloxamer P407 and silicon dioxide (SiO2) concentrations. The study aimed to compare the mechanical properties and biological parameters (bone remodeling, BSM degradation) of a hydroxyapatite: silica (HA)-based BSM with various P407 hydrogels in vitro and in an in vivo rat model. Rheological analyses for mechanical properties were performed on one BSM with an SiO2-enriched hydrogel (SPH25) as well on two BSMs with unaltered hydrogels in different gel concentrations (PH25 and PH30). Furthermore, the solubility of all BSMs were tested. In addition, 30 male Wistar rats underwent surgical creation of a well-defined bone defect in the tibia. Defects were filled randomly with PH30 (n = 15) or SPH25 (n = 15). Animals were sacrificed after 12 (n = 5 each), 21 (n = 5 each), and 63 days (n = 5 each). Histological evaluation and histomorphometrical quantification of new bone formation (NB;%), residual BSM (rBSM;%), and soft tissue (ST;%) was conducted. Rheological tests showed an increased viscosity and lower solubility of SPH when compared with the other hydrogels. Histomorphometric analyses in cancellous bone showed a decrease of ST in PH30 (p = .003) and an increase of NB (PH30: p = .001; SPH: p = .014) over time. A comparison of both BSMs revealed no significant differences. The addition of SiO2 to a P407 hydrogel-based hydroxyapatite BSM improves its mechanical stability (viscosity, solubility) while showing similar in vivo healing properties compared to PH30. Additionally, the SiO2-enrichment allows a reduction of poloxamer ratio in the hydrogel without impairing the material properties.

Fracture strength of monolithic and glass-soldered ceramic subcomponents of 5-unit fixed dental prosthesis.

PURPOSE: Zirconium dioxide ceramic has been successfully introduced as a framework material for fixed dental prostheses. To reduce manufacturing constraints, joining of subcomponents could be a promising approach to increase the mechanical performance of long-span fixed dental prostheses. In this experimental study, the biomechanical behavior of monolithic and soldered framework specimens for fixed dental prostheses made of Y-TZP was investigated. MATERIALS AND METHODS: Framework specimens (n = 80) of 5-unit fixed dental prostheses made of Y-TZP were prepared and divided into 10 equal groups. The specimens were monolithic or composed of subcomponents, which were joined using a silicate-based glass solder. Thereby, three joint geometries (diagonal, vertical with an occlusal cap, and dental attachment-based) were investigated. Moreover, the groups differed based on the mechanical test (static vs. dynamic) and further processing (veneered vs. unveneered). The framework specimens were cemented on alumina-based jaw models, where the canine and second molar were acting as abutments before a point-load was applied. In addition, µCT scans and microscopic fractography were used to evaluate the quality of soldered joints and to determine the causes of fracture. RESULTS: The determined fracture loads of the different unveneered framework specimens in static testing did not vary significantly (p = 1). Adding a veneering layer significantly increased the mechanical strength for monolithic framework specimens from 1196.29 ± 203.79 N to 1606.85 ± 128.49 N (p = 0.008). In case of soldered specimens with a dental attachment-based geometry, the mechanical strength increased from 1159.42 ± 85.65 N to 1249.53 ± 191.55 N (p = 1). Within the dynamic testing, no differences were observed between monolithic and soldered framework specimens. µCT scans and fractography proved that the dental attachment-based joining geometry offers the highest quality. CONCLUSION: Using glass soldering technology, subcomponents of 5-unit framework specimens made of Y-TZP could be joined with mechanical properties comparable to those of monolithic frameworks.

The implant surface and its role in affecting the dynamic processes of bone remodeling by means of distance osteogenesis: A comparative in vivo study.

PURPOSE: This study aimed to evaluate whether different surface modifications affect the dynamics of bone remodeling at the implant and the adjacent local bone. MATERIALS AND METHODS: Seventy-two dental implants with different surfaces (smooth and rough control [smCtrl; rCtrl], smooth and rough + O2-plasma spray [smPlas; rPlas], smooth and rough + nanocrystalline SiO2-hydroxyapatite coating [ncSiO2HA] + O2-plasma spray [smNB-C; rNB-C]; each n = 12) were bilaterally inserted into the femora of 36 New Zealand white rabbits. Intravital fluorochrome labeling was performed to visualize the dynamics of bone formation. The objectives were quantification of bone-to-implant contact (BIC [%]) at 2 and 4 weeks and the dynamic bone formation (dbf [%]) at the implants' adjacent local bone within 1, 2, and 3 weeks. RESULTS: After 2 weeks, BIC was significantly higher for both smNB-C (BIC: 59% ± 2% SEM) and rNB-C (BIC: 66% ± 3% SEM) compared with controls (BIC: 42% ± 1% SEM; P < .005). After 4 weeks, BIC for rNB-C (65% ± 2%) was superior to all test groups (BIC: 39% ± 2% SEM; P = .012). Regarding dbf (%), neither within 1 (P = .88), 2 (P = .48), nor after 3 weeks (P = .36) did any differences occur among the groups, even in accordance to the implant level. CONCLUSION: Although distance osteogenesis seems crucial for the development of secondary stability and thus of osseointegration, it apparently does not get affected by a bioactive ncSiO2HA surface coating. Changing the surfaces' release kinetics and composition may increase distance osteogenesis.

Hydrogel-embedded nanocrystalline hydroxyapatite granules (elastic blocks) based on a cross-linked polyvinylpyrrolidone as bone grafting substitute in a rat tibia model.

PURPOSE: The aim of this study was to examine the in vivo characteristics and levels of integration and degradation of a ready-to-use bone grafting block with elastic properties (elastic block) for the use in surgery. MATERIALS AND METHODS: Thirty-six male Wistar rats underwent surgical creation of a well-defined bone defect in the tibia. All created defects - one per animal - were filled with an unsintered nanocrystalline hydroxyapatite embedded either with a non-cross-linked hydrogel carrier (CONT, n=18) or a cross-linked hydrogel carrier (elastic block [EB], n=18) based on polyvinylpyrrolidone (PVP) and silica sol, respectively. The animals were killed after 12 (n=12), 21 (n=12) and 63 days (n=12). The bone formation and defect healing were quantified by histomorphometric measurements made in paraffin sections. Additionally, immunohistochemical (tartrate-resistant acid phosphatase [TRAP] and alkaline phosphatase [aP]), antibody-based examinations (CD68) and energy-dispersive x-ray scattering measurements of silica atom concentration were carried out. RESULTS: A larger remaining bone defect area overall was observed in EB after 12 days and 21 days. After 63 days, similar areas of remaining bone defects were found. The amount of the remaining carrier material in EB overall was higher at all times. In CONT no residual carrier material was found at 12 days and later. CD68 analyses showed significantly lower level of CD68-positive marked cells after 21 days in CONT, and nonsignificant differences at 12 and 63 days, respectively. Additionally, a significantly higher level of aP-positive marked cells was observed in CONT after 12 days. Later on, the levels of aP-positive marked cells were slightly higher in EB (21 and 63 days). Furthermore, no significant differences regarding the level of TRAP-positive marked cells in each group were observed. CONCLUSION: The bone substitute (EB) with the cross-linked PVP-based hydrogel carrier leads at the beginning to a higher amount of remaining carrier material and remaining bone substitute. This delayed degradation is supposed to be the reason for the observed lower level of bone remodeling and is caused by the irradiation changes (cross links) in the structure in PVP.

Silicon-dioxide-polyvinylpyrrolidone as a wound dressing for skin defects in a murine model.

OBJECTIVE: There is a high demand for temporary wound dressings that improve wound healing and regeneration. Silicon (as SiO2) has been shown to support the growth and collagen formation in biological systems. METHODS: A nanocomposite was made from PVP (polyvinylpyrrolidon), nano-sized silica aggregates and water and served for fabrication of a wet dressing material (SiO2-PVP gel, by cross-linking the gel) and a freeze-dried dressing material (SiO2-PVP fleece). Materials were characterized by SAXS, DSC, EDX and viscosity measurements. A 10 mm circular defect was set on both sides of the back of SKH1-hr mice (n = 40) and both dressing materials were compared with untreated controls. After 3, 6, 9, 12 and 15 days, the defect regions were explanted and evaluated by histomorphometric measurements and CD31-immunohistochemistry. RESULTS: The microstructure of the compound was composed of fiber like structures. SiO2 nano-aggregates inside the composite remained stable and embedded in a rigid amorphous PVP fraction. In animal experiments, all groups showed a non-irritated defect closure after 9 days. EDX of SiO2-PVP gel and fleeces revealed SiO2-PVP diffusion into the wound. Wound contraction was significantly enhanced after treatment with SiO2-PVP gel followed by SiO2-PVP fleece compared to controls. Re-epithelialization was increased in SiO2-PVP treated wounds and the regenerated epidermis showed a well-differentiated layer structure compared to untreated controls. CONCLUSIONS: The results indicate that silica diffuses from the dressing into the wound. Both dressings affect the wound healing. The SiO2-based wound dressing may counteract scarring and might be suitable as a temporary wound dressing.

In vivo and in vitro investigations of a nanostructured coating material - a preclinical study.

Immediate loading of dental implants is only possible if a firm bone-implant anchorage at early stages is developed. This implies early and high bone apposition onto the implant surface. A nanostructured coating material based on an osseoinductive bone grafting is investigated in relation to the osseointegration at early stages. The goal is to transmit the structure (silica matrix with embedded hydroxyapatite) and the properties of the bone grafting into a coating material. The bone grafting substitute offers an osseoinductive potential caused by an exchange of the silica matrix in vivo accompanied by vascularization. X-ray diffraction and transmission electron microscopy analysis show that the coating material consists of a high porous silica matrix with embedded nanocrystalline hydroxyapatite with the same morphology as human hydroxyapatite. An in vitro investigation shows the early interaction between coating and human blood. Energy-dispersive X-ray analysis showed that the silica matrix was replaced by an organic matrix within a few minutes. Uncoated and coated titanium implants were inserted into the femora of New Zealand White rabbits. The bone-to-implant contact (BIC) was measured after 2, 4, and 6 weeks. The BIC of the coated implants was increased significantly at 2 and 4 weeks. After 6 weeks, the BIC was decreased to the level of the control group. A histological analysis revealed high bone apposition on the coated implant surface after 2 and 4 weeks. Osteoblastic and osteoclastic activities on the coating material indicated that the coating participates in the bone-remodeling process. The nanostructure of the coating material led to an exchange of the silica matrix by an autologous, organic matrix without delamination of the coating. This is the key issue in understanding initial bone formation on a coated surface.

Evaluation of injectable silica-embedded nanohydroxyapatite bone substitute in a rat tibia defect model.

In clinical practice, vertebral compression fractures occur after trauma and osteoporosis. Kyphoplasty is a minimally invasive procedure using bone filler material for the treatment of such fractures. A full synthetic injectable bone substitute (SIBS) was manufactured by means of spray drying. The aim of this study was to characterize the SIBS and to analyze the remodelling process during degradation of the biomaterial and new bone formation after implantation. SIBS is an aqueous suspension of donut-like microparticles. These microparticles consist of nanocrystallites of synthetic hydroxyapatite embedded in amorphous silica gel. After implantation of SIBS in a proximal tibial diaphyseal defect in 52 rats, grafts were harvested for subsequent analysis on different days. Newly formed bone originating from endosteum was observed on day 6. Hematomas in the medullary space and cortical wounds disappeared on day 12. The wound region was completely replaced by a composite of newly formed cancellous bone, extracellular matrix, and SIBS. At day 63 the cortical defect was fully healed by bone, while newly formed bone in the medullary space almost disappeared and was replaced with bone marrow. In conclusion, SIBS demonstrated a unique structure with osteoinductive and bioresorbable properties, which induced fast bone regeneration. Therefore, a clinical application of SIBS for kyphoplasty is promising.