Biomedical Engineering Reference
In-Depth Information
4.4.3
How to Improve the Radiopacity of Bioactive Injectable
Bone Substitutes
115
4.4.4
BCP for Resorbable Osteosynthesis
118
4.4.5
BCP Scaffolds for Bone Tissue Engineering
120
4.4.6
BCP Scaffolds with Mesenchymal Stem Cells (MSC)
124
4.4.7
BCP Scaffolds for Growth Plate Chondrocyte Maturation
125
4.4.8
BCP Granules and Polymers for Injectable Bioceramics
125
4.4.8.1 Suspension
125
4.4.8.2 Self - Hardening Injectible - Mouldable Composite
126
4.4.9
BCP/Fibrin Glue
127
4.4.10 BCP Granules for Drug Delivery
128
4.5 Clinical Applications
129
4.5.1
Applications in Dentistry
129
4.5.1.1 Prevention of Bone Resorption
129
4.5.1.2 Sinus Lift Augmentation
130
4.5.2
Applications in Orthopedics
130
4.5.2.1 Cervical Spine Arthrodesis
131
4.5.2.2 Anterior Cervical Fusion with PEEK Cage
131
4.5.2.3 High Tibial Valgisation Osteotomy (HTO)
131
4.6 Conclusion
132
Acknowledgments
133
References
133
4.1 OVERVIEW
Developing calcium phosphate ceramics and other related biomaterials for bone
grafts requires better control of biomaterial resorption and bone substitution pro-
cesses. The biphasic calcium phosphate ceramics (BCP) concept is determined by
an optimum balance between the more stable HA phase and the more soluble
TCP. The material is soluble and gradually dissolves in the body, seeding new bone
formation as it releases calcium and phosphate ions into the biological medium.
The main attractive feature of BCP ceramic is its ability to form direct bone
bonding with host bone, resulting in a strong interface. The formation of this dy-
namic interface is the result of a sequence of events involving interaction between
biological fl uid and cells, as well as the formation of carbonated hydroxyapatite
(CHA), which is similar to bone mineral, by means of dissolution/precipitation
processes. Associating micro and macroporosity with the BCP chemical concept
resulted in high osteogenicity and osteoinductive properties. At the present time,
micro macroporous scaffolds are commercially available in blocks, particulates
and customised designs, and specifi c matrices have been developed for combina-
tion with bone marrow or mesenchymal stem cells for tissue engineering (hybrid
bone). The search for the ideal scaffold for tissue egineering and bone reconstruc-
tion in low trophic areas or large bone reconstruction remains a challenge, as
those currently available are not appropriate.
In addition, the need for material for Minimally Invasive Surgery (MIS) has
led to the development of a concept combining specifi c granules with polymer
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