Dataset Information

Tailored Three-Dimensionally Printed Triply Periodic Calcium Phosphate Implants: A Preclinical Study for Craniofacial Bone Repair.

ABSTRACT: Finding alternative strategies for the regeneration of craniofacial bone defects (CSD), such as combining a synthetic ephemeral calcium phosphate (CaP) implant and/or active substances and cells, would contribute to solving this reconstructive roadblock. However, CaP's architectural features (i.e., architecture and composition) still need to be tailored, and the use of processed stem cells and synthetic active substances (e.g., recombinant human bone morphogenetic protein 2) drastically limits the clinical application of such approaches. Focusing on solutions that are directly transposable to the clinical setting, biphasic calcium phosphate (BCP) and carbonated hydroxyapatite (CHA) 3D-printed disks with a triply periodic minimal structure (TPMS) were implanted in calvarial critical-sized defects (rat model) with or without addition of total bone marrow (TBM). Bone regeneration within the defect was evaluated, and the outcomes were compared to a standard-care procedure based on BCP granules soaked with TBM (positive control). After 7 weeks, de novo bone formation was significantly greater in the CHA disks + TBM group than in the positive controls (3.33 mm³ and 2.15 mm³, respectively, P=0.04). These encouraging results indicate that both CHA and TPMS architectures are potentially advantageous in the repair of CSDs and that this one-step procedure warrants further clinical investigation.

SUBMITTER: Pare A

PROVIDER: S-EPMC7064275 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Tailored Three-Dimensionally Printed Triply Periodic Calcium Phosphate Implants: A Preclinical Study for Craniofacial Bone Repair.

Paré Arnaud A Charbonnier Baptiste B Tournier Pierre P Vignes Caroline C Veziers Joëlle J Lesoeur Julie J Laure Boris B Bertin Hélios H De Pinieux Gonzague G Cherrier Grégory G Guicheux Jérome J Gauthier Olivier O Corre Pierre P Marchat David D Weiss Pierre P

ACS biomaterials science & engineering 20191122 1

Finding alternative strategies for the regeneration of craniofacial bone defects (CSD), such as combining a synthetic ephemeral calcium phosphate (CaP) implant and/or active substances and cells, would contribute to solving this reconstructive roadblock. However, CaP's architectural features (i.e., architecture and composition) still need to be tailored, and the use of processed stem cells and synthetic active substances (e.g., recombinant human bone morphogenetic protein 2) drastically limits t ...[more]

PMID: 32158932

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Project description:BackgroundAutologous bone grafts remain a standard of care for the reconstruction of large bony defects, but limitations persist. The authors explored the bone regenerative capacity of customized, three-dimensionally printed bioactive ceramic scaffolds with dipyridamole, an adenosine A2A receptor indirect agonist known to enhance bone formation.MethodsCritical-size bony defects (10-mm height, 10-mm length, full-thickness) were created at the mandibular rami of rabbits (n = 15). Defects were replaced by a custom-to-defect, three-dimensionally printed bioactive ceramic scaffold composed of β-tricalcium phosphate. Scaffolds were uncoated (control), collagen-coated, or immersed in 100 μM dipyridamole. At 8 weeks, animals were euthanized and the rami retrieved. Bone growth was assessed exclusively within scaffold pores, and evaluated by micro-computed tomography/advanced reconstruction software. Micro-computed tomographic quantification was calculated. Nondecalcified histology was performed. A general linear mixed model was performed to compare group means and 95 percent confidence intervals.ResultsQualitative analysis did not show an inflammatory response. The control and collagen groups (12.3 ± 8.3 percent and 6.9 ± 8.3 percent bone occupancy of free space, respectively) had less bone growth, whereas the most bone growth was in the dipyridamole group (26.9 ± 10.7 percent); the difference was statistically significant (dipyridamole versus control, p < 0.03; dipyridamole versus collagen, p < 0.01 ). There was significantly more residual scaffold material for the collagen group relative to the dipyridamole group (p < 0.015), whereas the control group presented intermediate values (nonsignificant relative to both collagen and dipyridamole). Highly cellular and vascularized intramembranous-like bone healing was observed in all groups.ConclusionDipyridamole significantly increased the three-dimensionally printed bioactive ceramic scaffold's ability to regenerate bone in a thin bone defect environment.

Project description:IntroductionCranioplasty is a common neurosurgical procedure, but infections can complicate it, necessitating revision surgery. Alloplastic patient-specific implants (PSI) are increasingly utilized, and different materials are available. This study evaluates the role of titanium-reinforced calcium-phosphate (CaP:Ti) implants in revision cranioplasty.Research questionAssessing the efficacy and safety of CaP:Ti PSI in patients requiring revision cranioplasty following complications with previously failed cranioplasty attempts.Material and methodsRetrospective analysis of 15 patients who underwent CaP:Ti PSI implantation for revision cranioplasty between 2016 and 2022 at a single neurosurgical department. Data on demographics, perioperative details, and outcomes were collected and assessed. Differences in distribution were assessed using Fisher's exact test, and groups were numerically compared using student's t-test. A p-value <0.05 was considered statistically significant.ResultsIn most patients, CP failure occurred early (38 days) following elective craniotomy for tumor and vascular procedures. The first revision cranioplasty was conducted in 12 cases using CaP:Ti PSI in 8 cases successfully requiring no further revision. Three cases implanted with other alloplastic materials required revision and received CaP:Ti PSI in the second (n = 2) or third (n = 1) CP attempt. The overall success rate for CaP:Ti PSI was 73.3% over more than two years of follow-up. success rate in revision cranioplasty. Surgical site complications, predominantly infections, were the main cause of CP failure. The average interval between implant removal and re-cranioplasty was 300 days. Prehabilitation using skin expanders and postoperative antibiotic use were strategies successfully utilized in this cohort.Discussion and conclusionOur findings suggest that CaP:Ti PSI implants hold promise in salvaging complicated cranioplasty in most cases despite challenges such as infection and implant failure. The use of techniques like skin expanders may contribute to better outcomes. However, further research is crucial to establish optimal timing and patient selection guidelines in revision cranioplasty using CaP:Ti implants, which could significantly impact future neurosurgical practices.

Dataset Information

Tailored Three-Dimensionally Printed Triply Periodic Calcium Phosphate Implants: A Preclinical Study for Craniofacial Bone Repair.

Publications

Tailored Three-Dimensionally Printed Triply Periodic Calcium Phosphate Implants: A Preclinical Study for Craniofacial Bone Repair.

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