Papers by Keyword: Clinical Cases

Abstract: There are numerous clinical indications for bone grafts. The ideal graft material should favor bone apposition and growth while simultaneously being degraded by body fluids and cells. Ultimately, the material should be replaced by mature bone tissue within a healing period of weeks. Because autologous and allogenic bone grafts fulfill some of these requirements, these biological materials are routinely used by clinicians. However, biological materials have intrinsic limitations. Harvesting autologous bone requires a second surgical site, which can cause complications, the material is limited in quantity, and it may lead to immunogenic rejection or transfer certain pathogens and viruses [1-3]. For these reasons, researchers and clinicians have developed synthetic bone substitutes. Our approach has focused on composite biomaterials that combine bioceramics with hydrogels to replace and regenerate bone tissue in osseous defects.

Abstract: The objective of this study deals with preclinical and clinical cases of absorbable composite interference screws of next generation in osteoarticular surgery. These implants are made of resorbable polymers PLA either amorphous or semi-cristalline, associated with granules of microporous biphasic calcium phosphate ceramic. A preclinical study was performed on goats in femoral and tibial epiphysis during 4 and 6 months. Histological and histomorphometric results were obtained by micro CT, light and scanning electron microscopy. The comparative statistical in vivo study of the kinetics of resorption and bone regeneration have shown the superiority of the composite compared to control (polymer alone). Thus the presence of Biphasic Calcium Phosphate granules in the composite has a major role for bone regeneration at the expense of the implant (buffering effect and properties of osteoconduction). An observational and functional study involving 10 patients, with a follow-up from 17 to 33 months (mean 25.7), was performed. Data were analyzed according to Good Clinical Practice and International Conference on Harmonisation. Clinical observations have revealed no complications and no serious event was reported; quantitative functional indices confirm the good observational results. The clinical study supports the functionality and performance of this new composite with properties of osteoconduction related to the osteogenicity of microporous biphasic calcium phosphate granules in the field of knee ligament fixation.

Abstract: Autogenous bone grafts are considered to be the gold standard in maxillo-facial surgery. However, drawbacks of donor site morbidity and unpredictable rates of resorbtion often limit their use. In vivo tests have shown that 45S5 bioactive glass particles placed in critical size bone defects lead to regeneration of new bone that has the structural characteristics and architecture of mature trabecular bone. In vitro tests using primary osteoblast cultures have shown that the bioactive glass particles release ionic dissolution products that provide genetic stimuli that control osteoblast cell cycles and lead to rapid growth of mineralized bone nodules. These in vitro and in vivo results led to approval of use of bioactive glass particles and monolithic bioactive glass implants for use in maxillo-facial reconstructions after removal of bone cysts and trauma, as described by several case histories.