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Journal articles on the topic 'Bone substitute'

Author: Grafiati
Published: 4 June 2021
Last updated: 14 March 2023

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1

Jhun, Jick Soo, Hui Suk Yun, Eui Kyun Park, and Hong In Shin. "Bone Repair Efficiency by Various Round Granular Bone Substitutes." Key Engineering Materials 493-494 (October 2011): 143–46. http://dx.doi.org/10.4028/www.scientific.net/kem.493-494.143.

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To improve the efficiency of osteogenic repair, we compared 3 types of round granular bone substitutes composed of hydroxyapatite (HA) in a single opened large pore covered by one or more thin shell structure, biphasic HA and tricalcium phosphate (TCP) in a compact granules with small uniform interconnected internal pores, and bioglass(BG) in a compact granules with hierarchical interconnected pores its bone repair efficiency by evaluation of cellular toxicity, cellular attachment and proliferation rate, and osteogenic supportive effect. They were nontoxic and revealed no noxious effect on cellular proliferation and osteoblastic differentiation. The cultured cells were most effectively proliferated on HA granular bone substitute surface. However, the bony repair of calvarial defects was most effective by BCP granular bone substitutes. The implanted BCP and HA granular bone substitutes showed excellent osteoconductive bone growth and favorable bone regeneration within 3 weeks compared to BG granular bone substitutes. All type granular bone substitutes were well incorporated into newly formed bone without foreign body reaction. Except for HA granular bone substitute, some implanted BG and BCP granular bone substitutes were partially resobed by TRAP positive multinucletated cells. These findings suggest that round granular biphasic calcium phosphate bone substitute structured with fully interconnected uniform sized internal pore might be a more promising bone substitute for small-sized none load-bearing bone defects.
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2

Yamada, M., T. Ueno, H. Minamikawa, N. Sato, F. Iwasa, N. Hori, and T. Ogawa. "N-acetyl Cysteine Alleviates Cytotoxicity of Bone Substitute." Journal of Dental Research 89, no. 4 (March 3, 2010): 411–16. http://dx.doi.org/10.1177/0022034510363243.

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Lack of cytocompatibility in bone substitutes impairs healing in surrounding bone. Adverse biological events around biomaterials may be associated with oxidative stress. We hypothesized that a clinically used inorganic bone substitute is cytotoxic to osteoblasts due to oxidative stress and that N-acetyl cysteine (NAC), an antioxidant amino acid derivative, would detoxify such material. Only 20% of rat calvaria osteoblasts were viable when cultured on commercial deproteinized bovine bone particles for 24 hr, whereas this percentage doubled on bone substitute containing NAC. Intracellular ROS levels markedly increased on and under bone substitutes, which were reduced by prior addition of NAC to materials. NAC restored suppressed alkaline phosphatase activity in the bone substitute. Proinflammatory cytokine levels from human osteoblasts on the bone substitute decreased by one-third or more with addition of NAC. NAC alleviated cytotoxicity of the bone substitute to osteoblastic viability and function, implying enhanced bone regeneration around NAC-treated inorganic biomaterials.
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3

Jung, Ki-Jin, Swapan Kumar Sarkar, Woo-Jong Kim, Bo-Ram Kim, Jong-Seok Park, and Byong-Taek Lee. "Bone Regeneration by Multichannel Cylindrical Granular Bone Substitute for Regeneration of Bone in Cases of Tumor, Fracture, and Arthroplasty." International Journal of Environmental Research and Public Health 19, no. 14 (July 6, 2022): 8228. http://dx.doi.org/10.3390/ijerph19148228.

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In orthopedics, a number of synthetic bone substitutes are being used for the repair and regeneration of damaged or diseased bone. The nature of the bone substitutes determines the clinical outcome and its application for a range of orthopedic clinical conditions. In this study, we aimed to demonstrate the possible applications of multichannel granular bone substitutes in different types of orthopedic clinical conditions, including bone tumor, fracture, and bone defect with arthroplasty. A clinical investigation on a single patient for every specific type of disease was performed, and patient outcome was evaluated by physical and radiographic observation. Brief physical characterization of the granular bone substitute and in vivo animal model investigation were presented for a comprehensive understanding of the physical characteristics of the granules and of the performance of the bone substitute in a physiological environment, respectively. In all cases, the bone substitute stabilized the bone defect without any complications, and the defect regenerated slowly during the postoperative period. Gradual filling of the defect with the newly regenerated bone was confirmed by radiographic findings, and no adverse effects, such as osteolysis, graft dispersion, and non-union, were observed. Homogeneous bone formation was observed throughout the defect area, showing a three-dimensional bone regeneration. High-strength multichannel granules could be employed as versatile bone substitutes for the treatment of a wide range of orthopedic conditions.
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Bedini, Rossella, Deborah Meleo, and Raffaella Pecci. "3D Microtomography Characterization of Dental Implantology Bone Substitutes Used In Vivo." Key Engineering Materials 541 (February 2013): 97–113. http://dx.doi.org/10.4028/www.scientific.net/kem.541.97.

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After a short introduction to bone substitute biomaterials and X-ray microtomography, this article describes a research work carried out for in-vitro characterization of bone substitute biomaterials as well as for in-vivo investigation of human bone grafted with biomaterials. Three different bone substitute biomaterials have been analyzed in-vitro by means of 3D microtomographic technique, while human bone samples grafted with bone substitute biomaterials are investigated by 3D microtomography and histological techniques. 3D images of bone substitutes and human bone samples with biomaterials have been obtained, together with morphometric parameters, by microtomography . 2D histological images have also been obtained by traditional technique only for human bone samples with biomaterials. Compared to traditional histological analysis, 3D microtomography shows better results for investigating bone tissue and bone substitute biomaterial, and in a short time. Nevertheless, histological analysis remains the best technique for the observation of soft tissue and blood vessels.
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5

Martin-Piedra, Miguel-Angel, Belén Gironés-Camarasa, Antonio España-López, Ricardo Fernández-Valadés Gámez, Cristina Blanco-Elices, Ingrid Garzón, Miguel Alaminos, and Ricardo Fernández-Valadés. "Usefulness of a Nanostructured Fibrin-Agarose Bone Substitute in a Model of Severely Critical Mandible Bone Defect." Polymers 13, no. 22 (November 15, 2021): 3939. http://dx.doi.org/10.3390/polym13223939.

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Critical defects of the mandibular bone are very difficult to manage with currently available materials and technology. In the present work, we generated acellular and cellular substitutes for human bone by tissue engineering using nanostructured fibrin-agarose biomaterials, with and without adipose-tissue-derived mesenchymal stem cells differentiated to the osteogenic lineage using inductive media. Then, these substitutes were evaluated in an immunodeficient animal model of severely critical mandibular bone damage in order to assess the potential of the bioartificial tissues to enable bone regeneration. The results showed that the use of a cellular bone substitute was associated with a morpho-functional improvement of maxillofacial structures as compared to negative controls. Analysis of the defect site showed that none of the study groups fully succeeded in generating dense bone tissue at the regeneration area. However, the use of a cellular substitute was able to improve the density of the regenerated tissue (as determined via CT radiodensity) and form isolated islands of bone and cartilage. Histologically, the regenerated bone islands were comparable to control bone for alizarin red and versican staining, and superior to control bone for toluidine blue and osteocalcin in animals grafted with the cellular substitute. Although these results are preliminary, cellular fibrin-agarose bone substitutes show preliminary signs of usefulness in this animal model of severely critical mandibular bone defect.
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6

Bornert, Fabien, François Clauss, Guoqiang Hua, Ysia Idoux-Gillet, Laetitia Keller, Gabriel Fernandez De Grado, Damien Offner, et al. "Mechanistic Illustration: How Newly-Formed Blood Vessels Stopped by the Mineral Blocks of Bone Substitutes Can Be Avoided by Using Innovative Combined Therapeutics." Biomedicines 9, no. 8 (August 3, 2021): 952. http://dx.doi.org/10.3390/biomedicines9080952.

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One major limitation for the vascularization of bone substitutes used for filling is the presence of mineral blocks. The newly-formed blood vessels are stopped or have to circumvent the mineral blocks, resulting in inefficient delivery of oxygen and nutrients to the implant. This leads to necrosis within the implant and to poor engraftment of the bone substitute. The aim of the present study is to provide a bone substitute currently used in the clinic with suitably guided vascularization properties. This therapeutic hybrid bone filling, containing a mineral and a polymeric component, is fortified with pro-angiogenic smart nano-therapeutics that allow the release of angiogenic molecules. Our data showed that the improved vasculature within the implant promoted new bone formation and that the newly-formed bone swapped the mineral blocks of the bone substitutes much more efficiently than in non-functionalized bone substitutes. Therefore, we demonstrated that our therapeutic bone substitute is an advanced therapeutical medicinal product, with great potential to recuperate and guide vascularization that is stopped by mineral blocks, and can improve the regeneration of critical-sized bone defects. We have also elucidated the mechanism to understand how the newly-formed vessels can no longer encounter mineral blocks and pursue their course of vasculature, giving our advanced therapeutical bone filling great potential to be used in many applications, by combining filling and nano-regenerative medicine that currently fall short because of problems related to the lack of oxygen and nutrients.
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7

Freischmidt, Holger, Jonas Armbruster, Emma Bonner, Thorsten Guehring, Dennis Nurjadi, Maren Bechberger, Robert Sonntag, Gerhard Schmidmaier, Paul Alfred Grützner, and Lars Helbig. "Systemic Administration of PTH Supports Vascularization in Segmental Bone Defects Filled with Ceramic-Based Bone Graft Substitute." Cells 10, no. 8 (August 11, 2021): 2058. http://dx.doi.org/10.3390/cells10082058.

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Non-unions continue to present a challenge to trauma surgeons, as current treatment options are limited, duration of treatment is long, and the outcome often unsatisfactory. Additionally, standard treatment with autologous bone grafts is associated with comorbidity at the donor site. Therefore, alternatives to autologous bone grafts and further therapeutic strategies to improve on the outcome and reduce cost for care providers are desirable. In this study in Sprague–Dawley rats we employed a recently established sequential defect model, which provides a platform to test new potential therapeutic strategies on non-unions while gaining mechanistic insight into their actions. The effects of a combinatorial treatment of a bone graft substitute (HACaS+G) implantation and systemic PTH administration was assessed by µ-CT, histological analysis, and bio-mechanical testing and compared to monotreatment and controls. Although neither PTH alone nor the combination of a bone graft substitute and PTH led to the formation of a stable union, our data demonstrate a clear osteoinductive and osteoconductive effect of the bone graft substitute. Additionally, PTH administration was shown to induce vascularization, both as a single adjuvant treatment and in combination with the bone graft substitute. Thus, systemic PTH administration is a potential synergistic co-treatment to bone graft substitutes.
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8

Titsinides, Savvas, Theodore Karatzas, Despoina Perrea, Efstathios Eleftheriadis, Leonidas Podaropoulos, Demos Kalyvas, Christos Katopodis, and George Agrogiannis. "Osseous Healing in Surgically Prepared Bone Defects Using Different Grafting Materials: An Experimental Study in Pigs." Dentistry Journal 8, no. 1 (January 9, 2020): 7. http://dx.doi.org/10.3390/dj8010007.

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Regeneration of large jaw bone defects still remains a clinical challenge. To avoid incomplete bone repair, bone grafts have been advocated to support the healing process. This study comparatively evaluated new bone formation among a synthetic graft substitute, a human bone derivative, and a bovine xenograft. Materials were placed in 3 out of the 4 bone cavities, while 1 deficit was left empty, serving as a control, in mono-cortical defects, surgically prepared in the porcine calvaria bone. Animals were randomized in 2 groups and euthanized at 8 and 12 weeks. Harvested tissue specimens were qualitatively evaluated by histology. New bone formation was quantitatively measured by histomorphometry. Maximum new bone formation was noticed in defects grafted with beta-tricalcium phosphate b-TCP compared to the other bone substitutes, at 8 and 12 weeks post-surgery. Bovine and human allograft induced less new bone formation compared to empty bone cavity. Histologic analysis revealed that b-TCP was absorbed and substituted significantly, while bovine and human allograft was maintained almost intact in close proximity with new bone. Based on our findings, higher new bone formation was detected in defects filled with b-TCP when compared to bovine and human graft substitutes.
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9

Chan, Kam-Kong, Chia-Hsien Chen, Lien-Chen Wu, Yi-Jie Kuo, Chun-Jen Liao, and Chang-Jung Chiang. "IN VIVO EVALUATION OF A NEW β-TRICALCIUM PHOSPHATE BONE SUBSTITUTE IN A RABBIT FEMUR DEFECT MODEL." Biomedical Engineering: Applications, Basis and Communications 27, no. 03 (May 28, 2015): 1550028. http://dx.doi.org/10.4015/s1016237215500283.

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Calcium phosphate ceramics, of a similar composition to that of mineral bone, and which possess the properties of bioactivity and osteoconductivity, have been widely used as substitutes for bone graft in orthopedic, plastic and craniofacial surgeries. A synthetic β-tricalcium phosphate, Osteocera™, a recently developed bone graft substitute, has been used in this study. To evaluate the affinity and efficacy of Osteocera™ as bone defect implant, we used a New Zealand white rabbit femur defect model to test the osteoconductivity of this new bone substitute. Alternative commercially available bone substitutes, Triosite® and ProOsteon500, were used as the control materials. These three bone substitutes show good biocompatibility, and no abnormal inflammation either infection was seen at the implantation sites. In the histological and histomorphometric images, newly formed bone grew into the peripheral pores in the bone substitutes. After six months implantation, the volume of bone formation was found to be 20.5 ± 5.2%, 29.8 ± 6.5% and 75.5 ± 4.9% of the potential total cavity offered by ProOsteon500, Triosite® and Osteocera™, respectively. The newly formed bone area within the femur defect section for Osteocera™ was significantly larger than ProOsteon500 and Triosite®. We concluded that Osteocera™ shows better bioresorbability, biocompatibility and osteoconductivity in the rabbit femur defect model.
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10

Cho, Tae Joon, and Ki Seok Lee. "Bone Graft Substitute." Journal of the Korean Fracture Society 19, no. 1 (2006): 109. http://dx.doi.org/10.12671/jkfs.2006.19.1.109.

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11

Resnick, Daniel K. "Vitoss Bone Substitute." Neurosurgery 50, no. 5 (May 2002): 1162–64. http://dx.doi.org/10.1227/00006123-200205000-00044.

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12

Shibuya, Naohiro, and Daniel C. Jupiter. "Bone Graft Substitute." Clinics in Podiatric Medicine and Surgery 32, no. 1 (January 2015): 21–34. http://dx.doi.org/10.1016/j.cpm.2014.09.011.

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13

Marshall, Andrew. "Photopolymerizable bone substitute." Nature Biotechnology 17, no. 2 (February 1999): 121. http://dx.doi.org/10.1038/6113.

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14

Paul, Nirvin, Raghavendra Kaganur, Anto Gopurathingal, Joseph George, and Abhishek Jirel. "Proximal Phalanx Enchondroma with Pathological Fracture Treated with Curettage and Bone Substitute Placement – A Case Report." Journal of Orthopaedic Case Reports 12, no. 10 (2022): 66–69. http://dx.doi.org/10.13107/jocr.2022.v12.i10.3370.

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Introduction: Enchondromas are predominantly seen in short tubular bones and are usually symptomless and the onset of pain may indicate a pathological fracture in most cases or malignant transformation in rare instances. Here, we report a case of proximal phalanx enchondroma with pathological fracture treated with synthetic bone substitute placement. Case Report: A 19-year-old girl presented to the outpatient department with complaints of swelling over the right little finger. She was evaluated for the same and a roentgenogram revealed a well-defined lytic lesion in the right little finger proximal phalanx. She was planned for conservative management, but she presented 2 weeks later with an increase in pain following trivial trauma. Conclusion: Synthetic bone substitutes are excellent materials for filling the void in benign conditions as they form resorbable scaffolds which have good osteoconductive properties and are associated with no donor site morbidity. Keywords: Enchondroma, curettage, bone substitute, bone morphogenic protein
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15

Thiery, Andreas, Octavian Tapos, and Konstantinos Anagnostakos. "Giant Solitary Cyst at the Site of Knee Osteoarthritis: Treatment with a Synthetic Resorbable Bone Graft Substitute and Primary Total Knee Arthroplasty." Case Reports in Orthopedics 2018 (July 18, 2018): 1–4. http://dx.doi.org/10.1155/2018/1693131.

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A 48-year-old male patient presented in our department with knee osteoarthritis and a giant cystic lesion of the lateral femoral condyle. Bone biopsy of the lesion was performed. Histopathological examination confirmed the presence of a solitary bone cyst. The patient was treated by curettage of the cyst, filling with a synthetic resorbable bone graft substitute (Cerament™), and primary, cruciate-retaining total knee arthroplasty. 4 months after surgery, complete osseointegration of the bone graft substitute was evident on X-rays. The use of modern bone graft substitutes might be a novel alternative to other established techniques in the management of large bone lesions, even at the site of primary total knee replacement.
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16

Zhao, Rusin, Ruijia Yang, Paul R. Cooper, Zohaib Khurshid, Amin Shavandi, and Jithendra Ratnayake. "Bone Grafts and Substitutes in Dentistry: A Review of Current Trends and Developments." Molecules 26, no. 10 (May 18, 2021): 3007. http://dx.doi.org/10.3390/molecules26103007.

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After tooth loss, bone resorption is irreversible, leaving the area without adequate bone volume for successful implant treatment. Bone grafting is the only solution to reverse dental bone loss and is a well-accepted procedure required in one in every four dental implants. Research and development in materials, design and fabrication technologies have expanded over the years to achieve successful and long-lasting dental implants for tooth substitution. This review will critically present the various dental bone graft and substitute materials that have been used to achieve a successful dental implant. The article also reviews the properties of dental bone grafts and various dental bone substitutes that have been studied or are currently available commercially. The various classifications of bone grafts and substitutes, including natural and synthetic materials, are critically presented, and available commercial products in each category are discussed. Different bone substitute materials, including metals, ceramics, polymers, or their combinations, and their chemical, physical, and biocompatibility properties are explored. Limitations of the available materials are presented, and areas which require further research and development are highlighted. Tissue engineering hybrid constructions with enhanced bone regeneration ability, such as cell-based or growth factor-based bone substitutes, are discussed as an emerging area of development.
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Hassan, Mozan, Mohsin Sulaiman, Priya Dharshini Yuvaraju, Emmanuel Galiwango, Ihtesham ur Rehman, Ali H. Al-Marzouqi, Abbas Khaleel, and Sahar Mohsin. "Biomimetic PLGA/Strontium-Zinc Nano Hydroxyapatite Composite Scaffolds for Bone Regeneration." Journal of Functional Biomaterials 13, no. 1 (January 28, 2022): 13. http://dx.doi.org/10.3390/jfb13010013.

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Synthetic bone graft substitutes have attracted increasing attention in tissue engineering. This study aimed to fabricate a novel, bioactive, porous scaffold that can be used as a bone substitute. Strontium and zinc doped nano-hydroxyapatite (Sr/Zn n-HAp) were synthesized by a water-based sol-gel technique. Sr/Zn n-HAp and poly (lactide-co-glycolide) (PLGA) were used to fabricate composite scaffolds by supercritical carbon dioxide technique. FTIR, XRD, TEM, SEM, and TGA were used to characterize Sr/Zn n-HAp and the composite scaffolds. The synthesized scaffolds were adequately porous with an average pore size range between 189 to 406 µm. The scaffolds demonstrated bioactive behavior by forming crystals when immersed in the simulated body fluid. The scaffolds after immersing in Tris/HCl buffer increased the pH value of the medium, establishing their favorable biodegradable behavior. ICP-MS study for the scaffolds detected the presence of Sr, Ca, and Zn ions in the SBF within the first week, which would augment osseointegration if implanted in the body. nHAp and their composites (PLGA-nHAp) showed ultimate compressive strength ranging between 0.4–19.8 MPa. A 2.5% Sr/Zn substituted nHAp-PLGA composite showed a compressive behavior resembling that of cancellous bone indicating it as a good candidate for cancellous bone substitute.
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18

Shao, Anliang, You Ling, Liang Chen, Lina Wei, Changfa Fan, Dan Lei, Liming Xu, and Chengbin Wang. "GGTA1/iGb3S Double Knockout Mice: Immunological Properties and Immunogenicity Response to Xenogeneic Bone Matrix." BioMed Research International 2020 (June 4, 2020): 1–11. http://dx.doi.org/10.1155/2020/9680474.

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Background. Animal tissues and tissue-derived biomaterials are widely used in the field of xenotransplantation and regenerative medicine. A potential immunogenic risk that affects the safety and effectiveness of xenografts is the presence of remnant α-Gal antigen (synthesized by GGTA1 or/and iGb3S). GGTA1 knockout mice have been developed as a suitable model for the analysis of anti-Gal antibody-mediated immunogenicity. However, we are yet to establish whether GGTA1/iGb3S double knockout (G/i DKO) mice are sensitive to Gal antigen-positive xenoimplants. Methods. α-Gal antigen expression in the main organs of G/i DKO mice or bovine bone substitutes was detected via a standardized ELISA inhibition assay. Serum anti-α-Gal antibody titers of G/i DKO mice after immunization with rabbit red blood cells (RRBC) and implantation of raw lyophilized bone substitutes (Gal antigen content was 8.14±3.17×1012/mg) or Guanhao Biotech bone substitutes (50% decrease in Gal antigen relative to the raw material) were assessed. The evaluation of total serum antibody, inflammatory cytokine, and splenic lymphocyte subtype populations and the histological analysis of implants and thymus were performed to systematically assess the immune response caused by bovine bone substitutes and bone substitute grafts in G/i DKO mice. Results. α-Gal epitope expression was reduced by 100% in the main organs of G/i DKO mice, compared with their wild-type counterparts. Following immunization with RRBC, serum anti-Gal antibody titers of G/i DKO mice increased from 80- to 180-fold. After subcutaneous implantation of raw lyophilized bone substitutes and Guanhao Biotech bone substitutes into G/i DKO mice, specific anti-α-Gal IgG, anti-α-Gal IgM, and related inflammatory factors (IFN-γ and IL-6) were significantly increased in the raw lyophilized bone substitute group but showed limited changes in the Guanhao Biotech bone substitute group, compared with the control. Conclusion. G/i DKO mice are sensitive to Gal antigen-positive xenogeneic grafts and can be effectively utilized for evaluating the α-Gal-mediated immunogenic risk of xenogeneic grafts.
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19

Japour, Christopher, Renato Giorgini, Glenroy Aska, Mary Thomas, and Eric Reynolds. "Intraosseous Lipoma." Journal of the American Podiatric Medical Association 100, no. 6 (November 1, 2010): 487–92. http://dx.doi.org/10.7547/1000487.

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Intraosseous lipoma is a rare bone tumor that may be encountered in clinical practice. It is benign and is described as a well-defined, radiolucent lesion that must be differentiated from other lytic lesions. Most of these lesions may be treated without surgery; however, when surgery is needed, the classic approach involves curettage and packing using autologous bone grafts, allografts, or synthetic bone substitutes. This article reports two cases using a synthetic bone substitute, TheriLok, to fill the void made from surgical curettage of the intraosseous lipoma. Both patients tolerated the TheriLok bone substitute without developing adverse reactions and precluded the need for a secondary donor site. (J Am Podiatr Med Assoc 100(6): 487–492, 2010)
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20

Sferopoulos, N. K. "Autograft Transfer from the Ipsilateral Femoral Condyle in Depressed Tibial Plateau Fractures." Open Orthopaedics Journal 8, no. 1 (September 30, 2014): 310–15. http://dx.doi.org/10.2174/1874325001408010310.

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Introduction : The rationale for operative treatment of depressed tibial plateau fractures is anatomic reduction, stable fixation and grafting. Grafting options include autogenous bone graft or bone substitutes. Methods : The autograft group included 18 patients with depressed tibial plateau fractures treated with autogenous bone grafting from the ipsilateral femoral condyle following open reduction and internal fixation. According to Schatzker classification, there were 9 type II, 4 type III, 2 type IV and 3 type V lesions. The average time to union and the hospital charges were compared with the bone substitute group. The latter included 17 patients who had an excellent outcome following treatment of split and/or depressed lateral plateau fractures, using a similar surgical technique but grafting with bone substitutes (allografts). Results : Excellent clinical and radiological results were detected in the autograft group after an average follow-up of 28 months (range 12-37). The average time to union in the autograft group was 14 weeks (range 12-16), while in the bone substitute group it was 18 weeks (range 16-20). The mean total cost was 1276 Euros for the autograft group and 2978 Euros for the bone substitute group. Discussion : The use of autogenous graft from the ipsilateral femoral condyle following open reduction and internal fixation of depressed tibial plateau fractures provided enough bone to maintain the height of the tibial plateau and was not associated with any donor site morbidity. Using this method, the surgical time was not significantly elongated and the rehabilitation was not affected. It also exhibited faster fracture healing without postoperative loss of reduction and it was less expensive than the use of bone substitutes.
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Kuo, Yi-Jie, Chun-Jen Liao, Gary Rau, Chia-Hsien Chen, Chih-Hong Yang, and Yang-Hwei Tsuang. "THE USE OF POLY(L-LACTIC-CO-GLYCOLIC ACID)/TRICALCIUM PHOSPHATE AS A BONE SUBSTITUTE IN RABBIT FEMUR DEFECTS MODEL." Biomedical Engineering: Applications, Basis and Communications 22, no. 04 (August 2010): 263–70. http://dx.doi.org/10.4015/s1016237210002092.

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Autogenous bone grafting is still the gold standard for use in bone defects in orthopedic, plastic, and craniofacial surgeries. However, some patients are unable to provide sufficient quantity of bone and the high postoperative morbidity limits its clinical use. Currently, various bone substitutes are available for clinical applications, including calcium phosphate and biodegradable polyester. But hydroxyapatite is considered nondegradable and the degradation rate of biodegradable polyester is too fast, therefore both these biomaterials are hardly used clinically. To resolve this problem, we fabricated a biodegradable porous bone substitute by merging poly(L-lactic-co-glycolic acid) (PLGA) and β-tricalcium phosphate (TCP), such that the new bone substitute could provide the advantages of both the materials. The New Zealand white rabbit femur defect model was used to assess the biocompatibility and degree of osteoconduction of this new bone substitute. There was no inflammatory reaction at the PLGA/TCP grafting site based on our macroscopic observations. Three months after grafting, the cavity and central portion of the created defect within the rabbit femur was filled with newly formed bone. Furthermore, the new ingrown bone tissues readily matured to secondary bone with Haversian systems similar to the surrounding cancellous bone. We conclude that the newly fabricated PLGA/TCP shows both excellent biocompatibility and effective osteoconduction.
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Chen, Chia-Hsien, Chang-Jung Chiang, Gary Rau, Mao-Suan Huang, Kam Kong Chan, Chun-Jen Liao, and Yi-Jie Kuo. "IN VIVO EVALUATION OF A NEW BIPHASIC CALCIUM PHOSPHATE BONE SUBSTITUTE IN RABBIT FEMUR DEFECTS MODEL." Biomedical Engineering: Applications, Basis and Communications 24, no. 06 (December 2012): 537–48. http://dx.doi.org/10.4015/s1016237212500494.

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Calcium phosphate ceramic has been known for its properties of bioactivity and osteoconductivity and has been widely used in orthopedic, plastic and craniofacial surgeries. The biocompatibility, unlimited availability, lower morbidity for the patient and cost-effectiveness of calcium phosphate ceramics represent important advantages over other biological bone graft, such as autografts and allografts. A new synthetic biphasic calcium phosphate (BCP), Bicera™ (60% HA and 40% β-TCP), is manufactured by Wiltrom Co., Ltd., as a new bone graft substitute. It shows good biocompatibility without cytotoxicity in in vitro test. To evaluate the possible application for clinical use, we used New Zealand white rabbit femur defect model to compare the osteoconductivity of this new bone substitute to another commercially available bone substitute (Triosite®) which was used as the control material. According to the macroscopic observation, both bone substitutes show good biocompatibility and no abnormal inflammation either infection was seen at the implantation sites. X-rays image of implant sites at one month, three months and six months showed all implanted materials were well incorporated with host bone. All of them were not fully absorbed and replaced after six months implantation. In the histological and hitomorphometric data, new bone grew into the surface of the peripheral pores in both bone substitutes and increased over time. Moreover, the degree of bone regeneration appeared to be relatively greater in the specimens with Bicera™ when compared with Triosite®. We concluded that this new synthetic BCP (Bicera™) showed similar biocompatibility and osteoconductive characteristic comparing with commercial product Triosite® in rabbit femur defects model.
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Bidossi, Alessandro, Marta Bottagisio, Nicola Logoluso, and Elena De Vecchi. "In Vitro Evaluation of Gentamicin or Vancomycin Containing Bone Graft Substitute in the Prevention of Orthopedic Implant-Related Infections." International Journal of Molecular Sciences 21, no. 23 (December 4, 2020): 9250. http://dx.doi.org/10.3390/ijms21239250.

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Antibiotic-loaded bone graft substitutes are attractive clinical options and have been used for years either for prophylaxis or therapy for periprosthetic and fracture-related infections. Calcium sulfate and hydroxyapatite can be combined in an injectable and moldable bone graft substitute that provides dead space management with local release of high concentrations of antibiotics in a one-stage approach. With the aim to test preventive strategies against bone infections, a commercial hydroxyapatite/calcium sulfate bone graft substitute containing either gentamicin or vancomycin was tested against Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa, harboring different resistance determinants. The prevention of bacterial colonization and biofilm development by selected microorganisms was investigated along with the capability of the eluted antibiotics to select for antibiotic resistance. The addition of antibiotics drastically affected the ability of the selected strains to adhere to the tested compound. Furthermore, both the antibiotics eluted by the bone graft substitutes were able to negatively impair the biofilm maturation of all the staphylococcal strains. As expected, P. aeruginosa was significantly affected only by the gentamicin containing bone graft substitutes. Finally, the prolonged exposure to antibiotic-containing sulfate/hydroxyapatite discs did not lead to any stable or transient adaptations in either of the tested bacterial strains. No signs of the development of antibiotic resistance were found, which confirms the safety of this strategy for the prevention of infection in orthopedic surgery.
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Karadjian, Maria, Christopher Essers, Stefanos Tsitlakidis, Bruno Reible, Arash Moghaddam, Aldo Boccaccini, and Fabian Westhauser. "Biological Properties of Calcium Phosphate Bioactive Glass Composite Bone Substitutes: Current Experimental Evidence." International Journal of Molecular Sciences 20, no. 2 (January 14, 2019): 305. http://dx.doi.org/10.3390/ijms20020305.

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Standard treatment for bone defects is the biological reconstruction using autologous bone—a therapeutical approach that suffers from limitations such as the restricted amount of bone available for harvesting and the necessity for an additional intervention that is potentially followed by donor-site complications. Therefore, synthetic bone substitutes have been developed in order to reduce or even replace the usage of autologous bone as grafting material. This structured review focuses on the question whether calcium phosphates (CaPs) and bioactive glasses (BGs), both established bone substitute materials, show improved properties when combined in CaP/BG composites. It therefore summarizes the most recent experimental data in order to provide a better understanding of the biological properties in general and the osteogenic properties in particular of CaP/BG composite bone substitute materials. As a result, BGs seem to be beneficial for the osteogenic differentiation of precursor cell populations in-vitro when added to CaPs. Furthermore, the presence of BG supports integration of CaP/BG composites into bone in-vivo and enhances bone formation under certain circumstances.
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Kawecki, Fabien, Jessica Jann, Michel Fortin, François A. Auger, Nathalie Faucheux, and Julie Fradette. "Preclinical Evaluation of BMP-9-Treated Human Bone-like Substitutes for Alveolar Ridge Preservation following Tooth Extraction." International Journal of Molecular Sciences 23, no. 6 (March 18, 2022): 3302. http://dx.doi.org/10.3390/ijms23063302.

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The success of dental implant treatment after tooth extraction is generally maximized by preserving the alveolar ridge using cell-free biomaterials. However, these treatments can be associated with inflammatory reactions, leading to additional bone volume loss hampering dental implant positioning. Our group developed a self-assembled bone-like substitute constituted of osteogenically induced human adipose-derived stromal/stem cells (hASCs). We hypothesized that a bone morphogenetic protein (BMP) supplementation could improve the in vitro osteogenic potential of the bone-like substitute, which would subsequently translate into enhanced alveolar bone healing after tooth extraction. ASCs displayed a better osteogenic response to BMP-9 than to BMP-2 in monolayer cell culture, as shown by higher transcript levels of the osteogenic markers RUNX2, osterix (OSX/SP7), and alkaline phosphatase after three and six days of treatment. Interestingly, BMP-9 treatment significantly increased OSX transcripts and alkaline phosphatase activity, as well as pro-angiogenic angiopoietin-1 gene expression, in engineered bone-like substitutes after 21 days of culture. Alveolar bone healing was investigated after molar extraction in nude rats. Microcomputed tomography and histological evaluations revealed similar, or even superior, global alveolar bone preservation when defects were filled with BMP-9-treated bone-like substitutes for ten weeks compared to a clinical-grade biomaterial, with adequate gingival re-epithelialization in the absence of resorption.
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Yamaguchi, Yusuke, Tomonori Matsuno, Atsuko Miyazawa, Yoshiya Hashimoto, and Takafumi Satomi. "Bioactivity Evaluation of Biphasic Hydroxyapatite Bone Substitutes Immersed and Grown with Supersaturated Calcium Phosphate Solution." Materials 14, no. 18 (September 8, 2021): 5143. http://dx.doi.org/10.3390/ma14185143.

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Recently, the frequency of use of bone substitute materials for the purpose of bone augmentation has increased in implant treatment, but bone formation with bone substitute materials alone is limited. Calcification of bone in the body progresses as Ca2+, H2PO4-, and HPO42- in the body form hydroxyapatite (HA) crystals. In this study, therefore, we prepared a biphasic bone substitute with biological activity to promote bone formation by inducing precipitation and growth of HA crystals on the surface of a bone substitute and evaluated it. Biphasic bone substitute granules were prepared by immersing HA granules in a supersaturated calcium phosphate solution prepared by mixing five medical infusion solutions, the precipitate was analyzed, and the biological activities of biphasic HA granules were evaluated in vitro and in vivo. As a result, the precipitated calcium phosphate crystals were identified as low crystalline HA. On the surface of the HA granules, low-crystalline HA grew markedly as needle-shaped crystals and significantly promoted cell proliferation and bone differentiation. In animal experiments, biphasic HA granules had a significantly higher bone mineral density, new bone volume ratio, and new bone area ratio. Therefore, it suggests that biphasic hydroxyapatite is a useful bone substitute for bone augmentation in dental implant treatment.
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Marmotti, Antongiulio, Castoldi Filippo, Rossi Roberto, Alessia Tron, Francesco Giacalone, Stefano Marenco, Cristina Realmuto, et al. "Pre-Operative Bone Marrow-Derived Cell Mobilization by G-CSF Enhances Osseointegration of Bone Substitute In Patients Undergoing Surgery with High Tibial Valgus Osteotomy." Blood 116, no. 21 (November 19, 2010): 4773. http://dx.doi.org/10.1182/blood.v116.21.4773.4773.

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Abstract Abstract 4773 Introduction. Bone substitutes are widely used to improve bone repair in orthopaedic surgical procedures. Osseointegration is a slow process that takes place both at bone-implant interface and inside the tridimensional structure. The process might benefit from the addition of bone marrow-derived cells (BMC). In order to exploit this possible effects, a study protocol has been designed including preoperative BMC mobilization induced by granulocyte-colony stimulating factor (G-CSF). Aim of the study was to verify feasibility, safety and efficacy of BMC-mobilization in patients undergoing high tibial valgus osteotomy (HTVO). Patients and Methods. Overall, 24 patients undergoing medial open wedge HTVO to treat genu varum were enrolled in a prospective phase II trial. The osteotomy gap was filled by hydroxyapatite and tricalciumphosphate bone graft substitute. Two consecutive cohorts of 12 patients were assigned to receive (GROUP A) or not receive (GROUP B) a daily dose of 10 μ g/kg of G-CSF for 3 consecutive days, with an additional dose 4 hours before surgery. BMC mobilization was monitored by White Blood Cell (WBC) count and flow cytometry analysis of circulating CD34+ cells. All patients underwent a clinical (Lysholm Score and SF-36) and X-ray evaluation preoperatively, and at 1, 3 and 6 months after surgery. Anteroposterior standard radiographs were analysed to compare bone structure of the osteotomy areas. The percentage of integration at the interface between host bone and bone substitute (“host bone-substitute interface”) was estimated by 2 blinded observers. A computed tomography (CT) evaluation of the host bone-substitute interface was performed at 2 months. The osseointegration at the host bone-substitute interface was estimated through a semiquantitative score by 2 blinded observers and through a measure of bone density. Results. Patients of Groups A and B were well balanced in terms of age and clinical presentation. All patients of both groups completed the study. The most common adverse events among patients assigned to G-CSF were mild to moderate bone pain and muscle discomfort, well controlled by oral analgesics. There were no severe adverse events in both Group A and B, all patients are presently alive and well. Mobilization of CD34+ve cells occurred in all patients receiving G-CSF: mean preoperative WBC and CD34+ values were 39,09 × 103/μ l (21,57-51,11) and 131,58/ƒnμ l (29.1 - 404) in Group A, and 6,77 (2,8-12-06) and 7,67/μ l (5,4-12) in Group B, respectively. At the post-surgery clinical evaluation, patients of Group A experienced pain and a slight impairment in overall performance at 1 month assessment, whereas they displayed a slight increase in overall performance at 3 and 6 months compared to Group B. Semi-quantitative radiographic evaluation revealed a higher rate of bone substitute osseointegration in Group A than in Group B at 1, 3 and 6 months post-surgery. Also semiquantitative CT evaluation at 2 months showed an overall improved osseointegration at the host bone-substitute interface in Group A patients. Bone density was measured at the host bone-substitute interface by the Hounsfield score: Group A patients scored lower values at the upper interface compared to Group B, accordingly with advanced stage bone remodelling. The differences between Group A and B on assessment of host bone-substitute interface reached a statistical significance (p< 0,05). Bone mineral density at the host bone-substitute interface as measured with DEXA (Dual-energy X-ray absorptiometry), was lower, although without statistical significance, in Group A than in Group B, again suggesting a more advanced stage of bone remodelling in the treated group compared to controls. Conclusions. G-CSF administration given to induce pre-operative mobilization of bone marrow-derived cells: i. is feasible and safe in patients undergoing orthopaedic surgery; ii. allows the peripheral blood circulation of high numbers of CD34+ve cells; iii. may hasten bone graft substitute integration as suggested by both clinical and radiographical and CT evaluations. The enhanced osseointegration might be the result of a direct activity of G-CSF or of a cellular effect mediated by either hematopoietic or endothelial progenitors mobilized by G-CSF or by the combination of all these factors. Disclosures: No relevant conflicts of interest to declare.
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Rahyussalim, Ahmad Jabir, Sugeng Supriadi, Aldo Fransiskus Marsetio, Pancar Muhammad Pribadi, and Bambang Suharno. "The potential of carbonate apatite as an alternative bone substitute material." Medical Journal of Indonesia 28, no. 1 (May 8, 2019): 92–7. http://dx.doi.org/10.13181/mji.v28i1.2681.

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Bone reconstructive surgery has become a common procedure, and bone transplantation has become the second most frequently performed tissue transplantation procedure worldwide. Therefore, the need for bone substitute materials has increased. Artificial bone substitutes exhibit osteoconductive properties and feature several advantages, including abundant resources, low cost, and low donor site morbidity. Carbonate apatite (CO3Ap) is a calcium phosphate ceramic that can be used as a synthetic bone graft. The carbonate content of this ceramic is similar to that of bone apatite. In this review, we show that carbonate apatite can be degraded given its chemical reactivity in a weakly acidic environment and through osteoclast resorption. Moreover, it is osteoconductive and promotes bone tissue formation without fibrotic tissue formation. Additionally, microstructural analysis revealed that new bone tissue is formed within the bone graft itself.
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Przekora, Agata, and Grażyna Ginalska. "Biological properties of novel chitosan-based composites for medical application as bone substitute." Open Life Sciences 9, no. 6 (June 1, 2014): 634–41. http://dx.doi.org/10.2478/s11535-014-0297-y.

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AbstractHydroxyapatite is the main inorganic component of bones and teeth. In order to improve mechanical properties and surgical handiness of bioceramics, a plasticizing agent e.g. polysaccharide can be added. Chitosan is a polysaccharide with biological properties that make it an ideal component of bioceramics-based composites for medical application as bone substitute. In this study, biocompatibility of two types of novel krill chitosan-based composites was evaluated. In vitro experiments were carried out using human foetal osteoblast cell line. Cytotoxicity, cell adhesion, and bone ALP activity tests were performed to assess biocompatibility of the composites. Osteoblast growth on composites was observed using confocal microscope. Our results demonstrated that fabricated novel composites are non-toxic, are favorable to cell adhesion and growth, and provoke increase in b-ALP activity with time, thus inducing osteoblast differentiation. Based on this data composites have promising clinical potential as a bone defect filler in regenerative medicine. It is worth emphasizing that our work resulted in fabrication of flexible and surgical handy, bone substitutes that possess absolute biocompatibility with structural and mechanical properties similar to trabecular bone.
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Ciobanu, Petru, Andrian Panuta, Iulian Radu, Norin Forna, Stefanita Arcana, Razvan Tudor, Alexandru Covaciu, Victor Niculescu, Vladimir Poroch, and Bogdan Puha. "Treatment of Bone Defects Resulted after Excision of Enchondroma of the Hand in 15 Patients, Comparing the Techniques of Autologous Bone Graft, Injectable Bone Substitute and Spontaneous Healing." Applied Sciences 12, no. 3 (January 26, 2022): 1300. http://dx.doi.org/10.3390/app12031300.

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Background: Enchondroma is the most common benign bone tumor of the hand. Surgical excision of the tumor using curettage is the treatment of choice. The management of the resulting defects is still a controversial topic in the literature. Methods: This retrospective study includes 15 patients diagnosed with solitary enchondroma in the hand bones: eight cases with type A, three cases with type B and four cases with type D according to Takigawa classification. The aim of this study was to compare the course and outcome in the three patient groups treated by curettage associated with natural consolidation of the bone defect, autologous bone graft or injectable synthetic bone substitute in association with plate and screw osteosynthesis. Results: Outcomes were assessed using the DASH score (mean score 2.5) and TAM score (excellent in all patients) with no significant functional differences between the three groups. Defects managed with k-IBS® injectable bone substitute were associated with shorter operating time, simpler surgical technique and less postoperative pain assessed by VAS score. Conclusion: The use of k-IBS® bone substitute is efficient and less technically demanding than autologous bone grafting. The Takigawa classification could be a good indicator for treatment choice.
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Pepelassi, Eudoxie, Despina Perrea, Ismene Dontas, Christian Ulm, Ioannis Vrotsos, and Stefan Tangl. "Porous Titanium Granules in comparison with Autogenous Bone Graft in Femoral Osseous Defects: A Histomorphometric Study of Bone Regeneration and Osseointegration in Rabbits." BioMed Research International 2019 (December 14, 2019): 1–12. http://dx.doi.org/10.1155/2019/8105351.

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Background. The high resorption rate of autogenous bone is a well-documented phenomenon that can lead to insufficient bone quality and quantity in an augmented area. Nonresorbable bone substitutes might perform better than autogenous bone in certain applications if they are able to provide adequate bone formation and graft osseointegration. Purpose. The aim of this study was to compare the osseous regeneration and graft integration in standardized defects in the rabbit femur treated either with porous titanium granules or autogenous osseous graft. Materials and Methods. Standardized femoral osseous defects were surgically induced in 45 New Zealand rabbits. Fifteen were treated with porous titanium granules (TIGRAN™-PTG) and membrane (PTGM), 15 with autogenous graft and membrane (AGM), and 15 with membrane alone (CM, control). At six weeks, the defects were assessed histologically and histomorphometrically. Results. PTGM as compared to AGM presented similar percentages of newly formed bone tissue, but a significantly higher fraction of the region of interest was filled with the bone substitute material. Accordingly, the composite of new bone plus bone substitute material showed significantly higher volumes for PTGM. Yet, the smaller amount of remaining autogenous bone was far better osseointegrated than the titanium granules, which in large regions showed no connection to newly formed bone. Both PTGM and AGM as compared to CM presented higher values of newly formed bone. Conclusions. This study demonstrated that PTG was similarly effective as autogenous osseous graft in achieving osseous regeneration while PTG performed markedly better in graft volume stability. The resulting higher total percentage of new bone combined with the bone substitute material in PTG could provide a superior foundation for implant placement.
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Scranton, Pierce E. "Use of Bone Graft Substitutes in Lower Extremity Reconstructive Surgery." Foot & Ankle International 23, no. 8 (August 2002): 689–92. http://dx.doi.org/10.1177/107110070202300802.

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Autologous iliac crest graft has been a standard source of supplementary bone for treating bony defects, fractures and arthrodeses. Bone graft substitutes have recently become widely available. This paper reports on the use of bone graft substitute in 28 patients that otherwise would have required an iliac crest graft. Twenty-four of the 28 operations were successful in the primary procedure with four patients requiring a second procedure that was then successful.
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Kim, Jooseong, Sukyoung Kim, and Inhwan Song. "Biomimetic Octacalcium Phosphate Bone Has Superior Bone Regeneration Ability Compared to Xenogeneic or Synthetic Bone." Materials 14, no. 18 (September 14, 2021): 5300. http://dx.doi.org/10.3390/ma14185300.

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Octacalcium phosphate (OCP) is a precursor of biological apatite crystals that has attracted attention as a possible bone substitute. On the other hand, few studies have examined this material at the experimental level due to the limitations on OCP mass production. Recently, mass production technology of OCP was developed, and the launch of OCP bone substitutes is occurring. In this study, the bone regeneration capacity of OCP products was compared with two of the most clinically used materials: heat-treated bovine bone (BHA) and sintered biphasic calcium phosphate (BCP). Twelve rabbits were used, and defects in each tibia were filled with OCP, BHA, BCP, and left unfilled as control (CON). The tibias were harvested at 4 and 12 weeks, and 15 μm slides were prepared using the diamond grinding method after being embedded in resin. Histological and histomorphometric analyses were performed to evaluate the bone regeneration ability and mechanism. The OCP showed significantly higher resorption and new bone formation in both periods analysed (p < 0.05). Overall, OCP bone substitutes can enhance bone regeneration significantly by activating osteoblasts and a rapid phase transition of OCP crystals to biological apatite crystals (mineralization), as well as providing additional space for new bone formation by rapid resorption.
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Kismiati, S., T. Yuwanta, Z. Zuprizal, S. Supadmo, and U. Atmomarsono. "Calcium deposition in egg due to substitution of limestone by eggshell flour in feed of laying hens." Journal of the Indonesian Tropical Animal Agriculture 43, no. 3 (August 23, 2018): 257. http://dx.doi.org/10.14710/jitaa.43.3.257-264.

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The aim of this research was to evaluate calcium deposition in egg using eggshell flour as a limestone substitute in feed. Two hundreds laying hen of Isa Brown strain of 25 weeks were used in this study. Treatments were diet with 7.5% limestone as control (T0), 2.5% limestone is substituted with eggshell flour(T1), 5% limestone is substituted with eggshell flour (T2) and limestone is substituted with eggshell flour (T3). A completly randomized design were used to allocated the treatments with 5 replications of each. Each experimental unit consists of 10 laying hens. Parameters measured were egg weight, yolk weight, albumen weight, eggshell weight, calcium of egg (yolk, albumen and eggshell), length, weight and Ca of tibia bone. The results showed that substitution of limestone with eggshell flour had significantly effect (P<0.05) on eggshell weight, Ca deposition on yolk, albumen, and Ca of tibia bone but non significantly effect on egg weight, weight and percentage of yolk, weight and percentage of albumen, percentage and Ca of eggshell, length and weight of tibia bone. In conclusion, calcium deposition in yolk was the highest in the use of 7.5% eggshell flour to substitute limestone but obtained the lowest Ca of bone , while calcium deposition in albumen was the highest in the use of 2.5% eggshell flour.
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Fernandes, Ytalo, Rafael Mantovani, Danilo Reino, Arthur Novaes, Michel Messora, Luiz Gustavo Sousa, Daniela Palioto, and Sergio Scombatti de Souza. "Evaluation of a New Porcine Bone Graft on the Repair of Surgically Created Critical Bone Defects in Rat Calvaria: Histomorphometric and Microtomographic Study." Journal of Functional Biomaterials 13, no. 3 (August 23, 2022): 124. http://dx.doi.org/10.3390/jfb13030124.

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The aim of this study was to evaluate the use of a new porcine bone graft in rat calvaria bone defects. Critical defects were surgically created in 24 rats that were divided into four experimental groups according to defect filling (n = 6): Control Group (CG)—blood clot; Porcine Bone Group (PG)—porcine-derived bone substitute; (BG): Bio-Oss Group (BG)–chemically and heat-treated bovine graft; Bonefill Group (BFG)—chemically treated bovine bone substitute. Euthanasia of the animals occurred 30 days after the surgery, and the area of the original surgical defect and the surrounding tissues were removed for micro-CT and histomorphometric analysis. In the micro-CT evaluation, the PG presented statistically significant differences (p < 0.05) in comparison to the CG, BG and BFG, for the parameters percentage of Bone Volume (BV/TV), Surface Bone Density (BS/TV), Number of Trabeculae (Tb.N) and Bone Connectivity (Conn), but not for Total Porosity (Po.tot) and Trabecular Thickness (Tb.Th). The histomorphometric analysis showed that the PG presented similar results to the BG regarding newly formed bone extension and to the BG and BFG regarding newly formed bone area. The porcine-derived graft presented superior microtomographic and histomorphometric results when compared to the two bovine bone substitutes.
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Mahan, KT, and MJ Carey. "Hydroxyapatite as a bone substitute." Journal of the American Podiatric Medical Association 89, no. 8 (August 1, 1999): 392–97. http://dx.doi.org/10.7547/87507315-89-8-392.

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A bone substitute eliminates the need for autogenous and allogeneic bone grafting, along with the complications unique to each. Coralline hydroxyapatite is a synthetic bone void filler manufactured from marine coral, which has a natural trabecular structure similar to that of cancellous bone. While initial studies have been promising, the use of coralline hydroxyapatite may be limited in the foot and ankle owing to its inherent mechanical weakness and lack of biodegradation. In this retrospective study, 20 patients who received coralline hydroxyapatite implants were reviewed to determine associated complications and host reaction to the material. The results indicate that the material is biologically inert and safe to use as a small-defect filler in low-load applications. Long-term clinical trials are needed to determine the indications for this material in the foot and ankle.
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Smeets, Ralf. "Risks for bone substitute materials." Clinical Oral Implants Research 29 (October 2018): 20. http://dx.doi.org/10.1111/clr.17_13355.

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Glazebrook, Mark, Alastair Younger, Paul Zamora, and Karl-Andre Lalonde. "B2A peptide bone graft substitute." Current Orthopaedic Practice 24, no. 5 (2013): 482–86. http://dx.doi.org/10.1097/bco.0b013e3182a44684.

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Landi, E., G. Celotti, G. Logroscino, and A. Tampieri. "Carbonated hydroxyapatite as bone substitute." Journal of the European Ceramic Society 23, no. 15 (January 2003): 2931–37. http://dx.doi.org/10.1016/s0955-2219(03)00304-2.

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Lawless, M. W., R. T. Laughlin, J. M. Kerpsack, and D. Pisut. "TOBRAMYCIN ELUTION FROM BONE SUBSTITUTE." Journal of Musculoskeletal Research 04, no. 02 (June 2000): 129–34. http://dx.doi.org/10.1142/s0218957700000100.

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Purpose: To determine the rate of antibiotic elution from tobramycin-impregnated ProOsteon (Interpore) and Collagraft (Zimmer). Methods: Five samples of Collagraft and ProOsteon were impregnated with a solution containing 1.2 g of tobramycin and 10 ml of sterile water. The samples were then allowed to dry overnight. These samples were stored at 37°C in separate test tubes containing phosphate buffered saline (PBS). The solution in each test tube was removed with a pipette at hours 3, 6, 9 and 12 and days 1, 2, 3, 5, 7, 9, 11 and 13. The PBS was then replaced. The pipetted solution was sent for laboratory quantification and also used in a bioassay to determine antibiotic level. To serve as a control, two additional samples of each bone graft that were not impregnated with antibiotic were placed in separate test tubes and subjected to the same protocol. Results: The antibiotic elution rate for both ProOsteon and Collagraft was high at 3 hours [5362 and 4875 μg/ml on day 3 (3.1 μg/ml) for the Collagraft and day 7 (3.7 μg/ml) for the ProOsteon]. Effective intravenous tobramycin level is considered to be 4–6 μg/ml. Conclusion: Bone graft substitute can be used as a delivery vehicle for tobramycin. In addition, antibiotic-impregnated synthetic bone graft may potentially fill a dead space or cavitary defect without the need for large autologous grafts and does not require later removal.
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Wang, Yingjie, Yanyan Bian, Lizhi Zhou, Bin Feng, Xisheng Weng, and Ruizheng Liang. "Biological evaluation of bone substitute." Clinica Chimica Acta 510 (November 2020): 544–55. http://dx.doi.org/10.1016/j.cca.2020.08.017.

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Knaack, David, M. E. P. Goad, Maria Aiolova, Christian Rey, Ali Tofighi, Pramod Chakravarthy, and D. Duke Lee. "Resorbable calcium phosphate bone substitute." Journal of Biomedical Materials Research 43, no. 4 (1998): 399–409. http://dx.doi.org/10.1002/(sici)1097-4636(199824)43:4<399::aid-jbm7>3.0.co;2-j.

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Heiner, Anneliese D., Robert A. Poggie, and Thomas D. Brown. "Flexural Rigidity of Laboratory and Surgical Substitutes for Human Fibular Bone Grafts." Journal of Musculoskeletal Research 02, no. 04 (December 1998): 267–72. http://dx.doi.org/10.1142/s0218957798000263.

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The purpose of this study was to measure flexural rigidity of two new synthetic fibular graft substitutes, and compare these data to the flexural rigidity of natural human fibulas. These substitutes were composite fiberglass surrogate fibulas, to be used in laboratory experimental studies, and porous tantalum cylinders, being researched as a bone graft substitute. Ten fiberglass surrogate fibulas and 13 porous tantalum rods were tested in a 4-point bending fixture. Both types of fibular graft substitute had flexural rigidities comparable to natural human fibulas. The fiberglass surrogate fibulas had much less inter-specimen variability in flexural rigidity than did the natural human fibulas (6%/10% vs. 36%/52% for A-P/M-L directions). The surrogate fibula is therefore appropriate for use in laboratory experimental studies of fibular grafts which will undergo bending. The flexural rigidity of the porous tantalum rods increased with relative density to the 1.2 power, as suggested by theory and empirical data for porous solids; thus, porous tantalum density and rod diameter can be varied to obtain the desired flexural rigidity.
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Tecu, Camelia, Iulian Antoniac, Gultekin Goller, Baris Yavas, Dan Gheorghe, Aurora Antoniac, Ion Ciuca, Augustin Semenescu1, Anca Daniela Raiciu3, and Ioan Cristescu. "The Sintering Behaviour and Mechanical Properties of Hydroxyapatite - Based Composites for Bone Tissue Regeneration." Materiale Plastice 56, no. 3 (September 30, 2019): 644–48. http://dx.doi.org/10.37358/mp.19.3.5246.

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The developement and regeneration of healthy bone tissue is a complex process that includes the interaction of different cell types and requires a set of coordinated processes. The loss of bone tissue may occur due to various reasons: surgical removal, bone trauma (i.e., fractures) or systemic bone loss (i.e., osteoporosis). When the natural bone tissue is destroyed, the regeneration capacity of the bone is not always satisfactory. The result consists therefore in many functional and structural aberrations. In order to improve and accelerate the healing process, bone substitutes have been developed. Hydroxyapatite has been widely used in bone applications due to its excellent biocompatibility, osteoconductivity and bioactivity [1,2]. The objective of this research is to obtain a new composite biomaterial that can be used as bone substitute. In this study, bovine hydroxyapatite obtained from freshly calcined bovine femur was used. The objective of this research is to obtain a new composite biomaterial that can be used as bone substitute. The experimental composite samples were obtained using bovine hydroxyapatite as matrix and tricalcium phosphate, respectively, magnesium oxide as reinforcement materials. The synthesis process of these new biomaterial composites, the effect of chemical composition, surface structure, chemical and phase composition as well as mechanical features have been investigated.
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Schwarz, Falko, Pedro Dünisch, Jan Walter, Yasser Sakr, Rolf Kalff, and Christian Ewald. "Cranioplasty after decompressive craniectomy: is there a rationale for an initial artificial bone-substitute implant? A single-center experience after 631 procedures." Journal of Neurosurgery 124, no. 3 (March 2016): 710–15. http://dx.doi.org/10.3171/2015.4.jns159.

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OBJECT The complication rate for cranioplasty after decompressive craniectomy is higher than that after other neurosurgical procedures; aseptic bone resorption is the major long-term problem. Patients frequently need additional operations to remove necrotic bone and replace it with an artificial bone substitute. Initial implantation of a bone substitute may be an option for selected patients who are at risk for bone resorption, but this cohort has not yet been clearly defined. The authors’ goals were to identify risk factors for aseptic bone flap necrosis and define which patients may benefit more from an initial bone-substitute implant than from autograft after craniectomy. METHODS The authors retrospectively analyzed 631 cranioplasty procedures (503 with autograft, 128 with bone substitute) by using a stepwise multivariable logistic regression model and discrimination analysis. RESULTS There was a significantly higher risk for reoperation after placement of autograft than after placement of bone substitute; aseptic bone necrosis (n = 108) was the major problem (OR 2.48 [95% CI1.11–5.51]). Fragmentation of the flap into 2 or more fragments, younger age (OR 0.97 [95% CI 0.95–0.98]; p < 0.001), and shunt-dependent hydrocephalus (OR 1.73 [95% CI1.02–2.92]; p = 0.04) were independent risk factors for bone necrosis. According to discrimination analysis, patients younger than 30 years old and older patients with a fragmented flap had the highest risk of developing bone necrosis. CONCLUSIONS Development of bone flap necrosis is the main concern in long-term follow-up after cranioplasty with autograft. Patients younger than 30 years old and older patients with a fragmented flap may be candidates for an initial artificial bone substitute rather than autograft.
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46

Rolvien, Tim, Mike Barbeck, Sabine Wenisch, Michael Amling, and Matthias Krause. "Cellular Mechanisms Responsible for Success and Failure of Bone Substitute Materials." International Journal of Molecular Sciences 19, no. 10 (September 23, 2018): 2893. http://dx.doi.org/10.3390/ijms19102893.

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Bone grafts, i.e., autologous, allogeneic or synthetic bone substitute materials play an increasing role in reconstructive orthopedic surgery. While the indications and materials differ, it is important to understand the cellular mechanisms regarding their integration and remodeling, which are discussed in this review article. Osteoconductivity describes the new bone growth on the graft, while osteoinductivity represents the differentiation of undifferentiated cells into bone forming osteoblasts. The best case is that both mechanisms are accompanied by osteogenesis, i.e., bone modeling and remodeling of the graft material. Graft incorporation is mediated by a number of molecular pathways that signal the differentiation and activity of osteoblasts and osteoclasts (e.g., parathyroid hormone (PTH) and receptor activator of nuclear factor κβ ligand (RANKL), respectively). Direct contact of the graft and host bone as well as the presence of a mechanical load are a prerequisite for the successful function of bone grafts. Interestingly, while bone substitutes show good to excellent clinical outcomes, their histological incorporation has certain limits that are not yet completely understood. For instance, clinical studies have shown contrasting results regarding the complete or incomplete resorption and remodeling of allografts and synthetic grafts. In this context, a foreign body response can lead to complete material degradation via phagocytosis, however it may also cause a fibrotic reaction to the bone substitute. Finally, the success of bone graft incorporation is also limited by other factors, including the bone remodeling capacities of the host, the material itself (e.g., inadequate resorption, toxicity) and the surgical technique or preparation of the graft.
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47

Lanao, R. P. Félix, J. W. M. Hoekstra, Joop G. C. Wolke, Sander C. G. Leeuwenburgh, A. S. Plachokova, O. C. Boerman, Jeroen J. J. P. van den Beucken, and John A. Jansen. "Bone Regenerative Properties of Injectable Calcium Phosphate/PLGA Cement in an Alveolar Bone Defect." Key Engineering Materials 529-530 (November 2012): 300–303. http://dx.doi.org/10.4028/www.scientific.net/kem.529-530.300.

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Periodontitis is one of the most common inflammatory diseases, which can lead to early tooth loss. The conventional treatment of periodontitis is to arrest the disease progression. Most reconstructive procedures involve application of bone substitutes, barrier membranes or a combination of both into the bony defects. Calcium phosphate cements (CPCs) are the predominant type of bone substitute material used for reasons of injectability and hence perfect filling potential for bone defects. Recently, injectable apatitic CPCs demonstrated to be more rapidly degradable when combined with poly (lactic-co-glycolic) acid (PLGA) microspheres. Further, PLGA microspheres can be used as a delivery vehicle for growth factors. In this study, the performance of injectable CPCs as a bone substitute material for alveolar bone defects created in Beagle dogs was evaluated. Four CPC-formulations were generated by incorporating hollow or dense PLGA microspheres, either or not loaded with the growth factors (platelet derived growth factor (PDGF) and insulin-like growth factor (IGF). Implantation period was 8 weeks. Bone formation was based on histological and histomorphometrical evaluation. The results demonstrated that filling alveolar bone defects with CPC-dense PLGA revealed significant more bone formation compared to CPC-hollow PLGA either or not loaded with IGF and PDGF. In summary, we conclude that injectable CPC-dense PLGA composites proved to be the most suitable material for a potential use as off the shelf material due to its good biocompatibility, enhanced degradability and subsequent bone formation.
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48

Sims, Margaret E., Barry W. Baker, and Robert M. Hoesch. "Tusk or Bone? An Example of Ivory Substitute in the Wildlife Trade." Ethnobiology Letters 2 (August 14, 2011): 40–44. http://dx.doi.org/10.14237/ebl.2.2011.27.

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Bone carvings (and other ivory substitutes) are common in the modern-day lucrative international ivory trade. Souvenirs for unknowing travelers and market shoppers can be made of non-biological material (plastic "ivory" beads) or skillfully crafted natural objects made to resemble something other than their true origin. Many of these items are received at the U. S. National Fish and Wildlife Forensics Laboratory (NFWFL) for species identification as part of law enforcement investigations. Morphologists at the Lab often receive uniquely carved ivory items that have been imported with little or no documentation. In recent years, analysts examined several purported ivory tusks suspected to be walrus, a protected marine mammal. After examination, the Lab determined their origin as carved leg bones of cattle using principles and methods of zooarchaeology and ancient DNA analysis. The naturally long and straight ungulate metapodials had been cut, carved, filled, stained, and polished to closely resemble unmodified ivory tusks. Morphological species identification of these bones proved to be a challenge since diagnostic characters of the bones had been altered and country of origin was unknown. Genetic analysis showed that the bones originated from cattle. While bone is commonly used as a substitute for ivory, this style of artifact was not previously documented in the wildlife trade prior to our analysis. Archaeological ethnobiologists commonly encounter bone tools and other forms of material culture from prehistoric and historic contexts; in this case bone tools come from a modern context, thus the application of methods common in zooarchaeology are situated in wildlife forensics. In addition, results reported here pertain to cross-cultural ivory trade and conservation science.
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49

Onisor, Florin, Simion Bran, Ileana Mitre, Alexandru Mester, Andrada Voina-Tonea, Gabriel Armencea, and Mihaela Baciut. "Polymer-Based Bone Substitutes in Periodontal Infrabony Defects: A Systematic Evaluation of Clinical Studies." Polymers 13, no. 24 (December 18, 2021): 4445. http://dx.doi.org/10.3390/polym13244445.

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Background and Objectives: The aim was to systematically review the available literature regarding the use of polymers as a bone substitute for the treatment of periodontal infrabony defect. Materials and methods: Three databases (PubMed, Scopus and Web of Science) were searched to find all relevant studies published in English from inception until September 2021 using a combination of keywords. The inclusion criteria consisted of human clinical studies which reported the use of a polymer-based bone substitute in the treatment of infrabony defects. Results: 164 studies were provided from the databases. Of these, five articles were eligible and reported favorable outcome in terms of probing depth, clinical attachment gain and defect fill at the follow-up (3 months and 6 months). Conclusions: Polymer based-bone substitutes may represent a useful alternative in treating infrabony defects. Due to the limited number of studies, more research is needed to sustain the advantages of these products.
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Lee, Si Woo, Ji-Young Kim, Ki Yong Hong, Tae Hyun Choi, Byung Jun Kim, and Sukwha Kim. "The effect of biphasic calcium phosphate and demineralized bone matrix on tooth eruption in mongrel dogs." Archives of Craniofacial Surgery 22, no. 5 (October 20, 2021): 239–46. http://dx.doi.org/10.7181/acfs.2021.00325.

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Background: Bone grafts can provide an optimal environment for permanent tooth to erupt and enhance the stability of the alveolar maxilla. Although autologous bone is an optimal source for osteogenesis, its inevitable donor site morbidity has led to active research on bone substitutes. This study was designed to evaluate the safety and feasibility of using biphasic calcium phosphate (BCP; Osteon) as a bone substitute in dogs. Methods: Bilateral third and fourth premolars of four 15-week-old mongrel dogs were used. All teeth were extracted except the third premolar of the right mandible, which was used as a control. After extraction of the premolars, each dog was administered BCP (Osteon), demineralized bone matrix (DBM; DBX), and no graft in the hollow sockets of the right fourth premolar, left fourth premolar, and left third premolar, respectively. Radiographs were taken at 2-week intervals to check for tooth eruption. After 8 weeks, each dog was sacrificed, and tooth and bone biopsies were performed to check for the presence of tooth and bone substitute particle remnants. Results: Four weeks after the operation, permanent tooth eruptions had started at all the extraction sites in each dog. Eight weeks after the operation, all teeth had normally erupted, and histological examination revealed BCP particles at the right fourth premolar. Conclusion: In all four dogs, no delay in the eruption of the teeth or shape disfigurement of permanent teeth was observed on gross inspection and radiologic evaluation. On histological examination, most of the BCP and DBM were replaced by new bone. Bone substitutes can be used as graft materials in patients with alveolar clefts.
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