Fast Degradable Calcium Phosphate Cement for Maxillofacial Bone Regeneration. 2023

Bart van Oirschot, and Antonios G Mikos, and Qian Liu, and Jeroen J J P van den Beucken, and John A Jansen
Department of Dentistry-Regenerative Biomaterials, Radboud University Medical Center, Nijmegen, The Netherlands.

The aim of this preclinical study was to test the applicability of calcium phosphate cement (CPC)-poly(lactic-co-glycolic acid) (PLGA)-carboxymethylcellulose (CMC) as a bone substitute material for guided bone regeneration (GBR) procedures in a clinically relevant mandibular defect model in minipigs. In the study, a predicate device (i.e., BioOss®) was included for comparison. Critical-sized circular mandibular bone defects were created and filled with either CPC-PLGA-CMC without coverage with a GBR membrane or BioOss covered with a GBR membrane and left to heal for 4 and 12 weeks to obtain temporal insight in material degradation and bone formation. Bone formation increased significantly for both CPC-PLGA-CMC and BioOss with increasing implantation time. Further, no significant differences were found for bone formation at either 4 or 12 weeks between CPC-PLGA-CMC and BioOss. Finally, bone substitute material degradation increased significantly for both CPC-PLGA-CMC and BioOss from 4 to 12 weeks of implantation, showing the highest degradation for CPC-PLGA-CMC (∼85%) compared to BioOss (∼12%). In conclusion, this minipig study showed that CPC-PLGA-CMC can be used as a bone-grafting material and stimulates bone regeneration to a comparable extent as with BioOss particles. Importantly, CPC-PLGA-CMC degrades faster compared to BioOss, is easier to apply into a bone defect, and does not need the use of an additional GBR membrane. Consequently, the data support the further investigation of CPC-PLGA-CMC in human clinical trials. Impact statement Guided bone regeneration (GBR) is a frequently used dental surgical technique to regenerate the alveolar ridge to allow stable implant installation. However, stabilization of the GBR membrane and avoidance of bone graft movement remain a challenge. Consequently, there is need for the development of alternative materials to be used in GBR procedures that are easier to apply and induce predictable bone regeneration. In this minipig study, we focused on the applicability of calcium phosphate cement-poly(lactic-co-glycolic acid)-carboxymethylcellulose as an alternative bone substitute material for GBR procedures without the need of an additional GBR membrane.

UI MeSH Term Description Entries
D001843 Bone Cements Adhesives used to fix prosthetic devices to bones and to cement bone to bone in difficult fractures. Synthetic resins are commonly used as cements. A mixture of monocalcium phosphate, monohydrate, alpha-tricalcium phosphate, and calcium carbonate with a sodium phosphate solution is also a useful bone paste. Bone Cement,Bone Glues,Bone Pastes,Bone Glue,Bone Paste,Cement, Bone,Cements, Bone,Glue, Bone,Glues, Bone,Paste, Bone,Pastes, Bone
D001861 Bone Regeneration Renewal or repair of lost bone tissue. It excludes BONY CALLUS formed after BONE FRACTURES but not yet replaced by hard bone. Osteoconduction,Bone Regenerations,Regeneration, Bone,Regenerations, Bone
D002130 Calcium Phosphates Calcium salts of phosphoric acid. These compounds are frequently used as calcium supplements. Phosphates, Calcium
D002266 Carboxymethylcellulose Sodium A cellulose derivative which is a beta-(1,4)-D-glucopyranose polymer. It is used as a bulk laxative and as an emulsifier and thickener in cosmetics and pharmaceuticals and as a stabilizer for reagents. Carboxymethyl Cellulose,Carboxymethylcellulose,Aquacel,Aquaplast,Carmellose Sodium,Cellolax,Cethylose,Croscarmellose Sodium,Polycell,Ruspol,Sodium Carboxymethylcellulose,Carboxymethylcellulose, Sodium,Cellulose, Carboxymethyl,Sodium, Carboxymethylcellulose,Sodium, Carmellose,Sodium, Croscarmellose
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077182 Polylactic Acid-Polyglycolic Acid Copolymer A co-polymer that consists of varying ratios of polylactic acid and polyglycolic acid. It is used as a matrix for drug delivery and for BONE REGENERATION. PLGA Acid,LactoSorb,PL-PG Copolymer,PLG Polymer,PLGA Compound,Poly (D,L-lactic-co-glycolic Acid),Poly (Lactic-co-glycolic Acid) -,Poly(D,L-lactide-co-glycolide),Poly(DL-lactide-co-glycolic Acid),Poly(Glycolide-co-lactide),Poly(L-lactide)-co-glycolide,Poly(Lactic-co-glycolic Acid),Poly-L-lactic-polyglycolic Acid,Polylactic-co-glycolic Acid Copolymer,RG 502,Acid, PLGA,Acids, PLGA,Copolymer, PL-PG,Copolymer, Polylactic-co-glycolic Acid,Copolymers, PL-PG,Copolymers, Polylactic-co-glycolic Acid,PL PG Copolymer,PL-PG Copolymers,PLG Polymers,PLGA Acids,PLGA Compounds,Poly L lactic polyglycolic Acid,Poly-L-lactic-polyglycolic Acids,Polylactic Acid Polyglycolic Acid Copolymer,Polylactic co glycolic Acid Copolymer,Polylactic-co-glycolic Acid Copolymers,Polymer, PLG,Polymers, PLG
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D013552 Swine Any of various animals that constitute the family Suidae and comprise stout-bodied, short-legged omnivorous mammals with thick skin, usually covered with coarse bristles, a rather long mobile snout, and small tail. Included are the genera Babyrousa, Phacochoerus (wart hogs), and Sus, the latter containing the domestic pig (see SUS SCROFA). Phacochoerus,Pigs,Suidae,Warthogs,Wart Hogs,Hog, Wart,Hogs, Wart,Wart Hog
D013556 Swine, Miniature Genetically developed small pigs for use in biomedical research. There are several strains - Yucatan miniature, Sinclair miniature, and Minnesota miniature. Miniature Swine,Minipigs,Miniature Swines,Minipig,Swines, Miniature
D018786 Bone Substitutes Synthetic or natural materials for the replacement of bones or bone tissue. They include hard tissue replacement polymers, natural coral, hydroxyapatite, beta-tricalcium phosphate, and various other biomaterials. The bone substitutes as inert materials can be incorporated into surrounding tissue or gradually replaced by original tissue. Bone Replacement Materials,Bone Replacement Material,Bone Substitute,Replacement Material, Bone,Replacement Materials, Bone,Substitutes, Bone,Material, Bone Replacement,Materials, Bone Replacement,Substitute, Bone

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