Biomedical Engineering Reference
In-Depth Information
despite over 25 years of research with extensive funding and over 12,000 papers on bone tissue
engineering and over 2000 papers on bone scaffolds alone in the past 10 years, there are very lim-
ited numbers of bone tissue engineering clinical products and auto or allo bone grafts remain the
gold standard and treatment of choice, for large defects, especially in craniomaxillofacial recon-
struction
[5]
. For any therapy to be successfully adapted for clinical use, there are significant tech-
nical, business, and philosophical barriers that must be overcome. It has been argued that the
technical challenges for scaffold translation alone are significant in that the materials must fill the
“Form, Fixation, Function and Formation needs”
[5]
of repair of bony defects. However, it has also
been noted that this can be best accomplished by targeting specific clinical applications and then
developing a material as a modular system with increasing levels of complexity as needed
[5]
. This
is the approach that appears to be emerging with the development of nanoceramics bone tissue
engineering therapies in the craniomaxillofacial and oral cavity (
Table 19.2
).
As pointed out in this chapter, nanohydroxyapatite is presently commercially available for clini-
cal use as Ostim
s
and nanOss
s
with complexity to the material recently introduced with nanOss
Bioactive
s
bone graft that utilizes a collagen- or gelatin-based biopolymer in addition to the nano-
HA material.
3
As further discussed here, nanomaterials such as the HA as well as bio active glass
and CS can be further fabricated with materials such as chitosan and alginate to modify the porosity
and growth factor delivery properties of the nanoscaffold for a more optimal functional form
designed for a particular clinical procedure. Although there are many components such as cell
sources, growth factors, and signaling pathways, in addition to the scaffold material, that have to be
considered in the fabrication of an ideal bone tissue engineered product, there is an ever increasing
body of basic and preclinical studies that suggest that nanoceramics will continue to play an
important role in the development of sound clinical therapeutics for repair of critical defects in the
craniofacial region as well as throughout the skeleton.
Acknowledgment
The authors are grateful for the clinical insight of Dr. Sebastiano Andreana throughout our work with CS and
especially during the preparation of this paper.
References
[1] R. Langer, J.P. Vacanti, Tissue engineering, Science 260 (1993) 920
926.
[2] P.G. Robey, Cell sources for bone regeneration: the good, the bad, and the ugly (but promising), Tissue
Eng. 17 (2011) 423
430.
[3] F.-M. Chen, M. Zhang, Z.-F. Wu, Toward delivery of multiple growth factors in tissue engineering,
Biomaterials 31 (2010) 6279
6308.
[4] Q.Chen,J.A.Roether,A.R.Boccaccini,Bioactive glass and composite materials, in: W. Ashammakhi,
R. Reis, F. Chiellini (Eds.), Topics in Tissue Engineering, vol. 4, 2008, pp. 1
27. Chapter 6
