磷酸钙陶瓷的理化性能与宿主组织的关系

磷酸钙陶瓷如磷酸三钙（TCP）和羟基磷灰石（HA）是常用人工骨替代材料,这些材料具有不同的理化性能,因而能与宿主组织发生不同的反应。多孔性、骨传导性、生物相容性均是研制人工骨替代材料时要考虑的重要因素。本介绍了磷酸钙陶瓷的理化性能与宿主组织之间的关系。     

复合磷酸钙陶瓷人工骨

磷酸钙陶瓷因具有良好的生物相容性和骨传导作用而成为人工骨的常用材料 ,但是 ,它们本身无骨诱导作用。将具有骨诱导作用的物质如 BMP、骨髓、生长因子等与磷酸钙陶瓷复合 ,可以克服磷酸钙陶瓷无骨诱导作用的缺陷     

脂肪间充质干细胞复合骨诱导性磷酸钙陶瓷支架的异位成骨CSCD

背景:生物材料的骨诱导现象已经在多种动物实验中被证实。目的:考察磷酸钙陶瓷自身固有的诱导骨生成能力在其作为骨组织工程支架时的表现。方法:取健康家犬10只,在每只的背部肌肉内分别植入骨诱导性磷酸钙陶瓷与自体脂肪间充质干细胞复合物、非骨诱导性磷酸钙陶瓷与自体脂肪间充质干细胞复合物、骨诱导性磷酸钙陶瓷及非骨诱导性磷酸钙陶瓷,植入后8,12周,取出植入材料及其周围组织进行Micro-CT检测和组织形态学检测,评价成骨情况。结果与结论:组织学观察结果显示,骨诱导性磷酸钙陶瓷组及骨诱导性磷酸钙陶瓷与自体脂肪间充质干细胞复合物组均有有异位骨生成,并且骨诱导性磷酸钙陶瓷与自体脂肪间充质干细胞复合物组的成骨量显著大于骨诱导性磷酸钙陶瓷组(P<0.05);其余两组均无异位成骨。Micro-CT检测结果与组织形态学检测结果一致。结果表明骨诱导性磷酸钙陶瓷作为骨组织工程支架材料有明显的成骨优势,而脂肪间充质干细胞作为种子细胞对异位成骨有明显的促进作用。     

骨诱导性双相磷酸钙陶瓷的研究与应用

背景：双相磷酸钙陶瓷是由羟基磷灰石和β-磷酸三钙两相成分构成的陶瓷,其化学组成与骨组织的无机成分相似,目前体内外研究表明双相磷酸钙陶瓷除具有良好的生物相容性、生物活性、骨传导性以外,还具有骨诱导性,因此有望成为理想的骨替代材料。然而,双相磷酸钙陶瓷骨诱导的影响因素及相关机制尚不明确。 目的：综述影响双相磷酸钙陶瓷骨诱导性的因素及机制。 方法：应用计算机检索Ovid Medline和PubMed数据库中1985年1月至2013年1月关于双相磷酸钙陶瓷骨诱导性的文章,在标题和摘要中以“bone graft substitutes, biphasic calcium phosphates, osteoinduction”为检索词进行检索。选择文章内容与双相磷酸钙陶瓷的骨诱导性有关者,同一领域文献则选择近期发表或发表在权威杂志的文章,最终选择34篇文献进行综述。 结果与结论：综合相关文献发现双相磷酸钙陶瓷的化学组成通过影响钙磷的降解和再沉积速率,进而影响其骨诱导性的发挥;同时双相磷酸钙陶瓷的物理结构通过影响骨形成相关蛋白的吸附、血管生成、组织长入、局部微环境并进一步诱发干细胞的骨向分化来影响双相磷酸钙陶瓷的骨诱导性;另外双相磷酸钙陶瓷植入动物的种属,植入部位及植入体大小也可对其骨诱导性产生影响。因此通过对双相磷酸钙陶瓷骨诱导性影响因素及相关机制的研究可为制备具有稳定骨诱导性的骨替代材料提供依据。     

磷酸钙陶瓷人工骨的研究

本文对磷酸钙陶瓷人工骨进行了综述。介绍了磷酸钙陶瓷的制备、生物学性能及作为人工骨的不足之处及改进方法。     

磷酸钙陶瓷人工骨的研究

本文对磷酸钙陶瓷人工骨进行了综述。介绍了磷酸钙陶瓷的制备、生物学性能及作为人工骨的不足之处及改进方法     

骨修复替代材料修复骨缺损的选择与应用

背景：在骨缺损治疗方面,近几年集中在骨修复替代材料领域出现了一系列重大科研突破,催生了很多全新的骨修复替代材料。目前临床上可供选择的骨修复替代材料种类繁多,各种材料的特性不同,各有优势和缺点。如何正确选择与应用是创伤骨科医师面临的实际问题,值得讨论和推敲。 目的：通过对自体骨、同种异体骨和人工骨材料在应用中的相关文献分析,评价3种骨修复替代材料的生物性能,有利于骨科医师更好的理解几种骨修复替代材料的理化、生物性能,进一步提高诊断和治疗水平。 方法：人工骨材料在骨缺损修复中起到不可取代的作用,并且也获得良好的临床效果,但近期临床效果并非是与传统材料的最终比较结果。人工骨材料安全性和稳定性的验证尚缺乏足够的实验依据,确切疗效尚须长期的临床观察。寻找具有良好生物特性的人工骨材料抑制是骨科的研究热点。分别对自体骨、同种异体骨、人工骨材料3种骨修复替代材料治疗骨缺损的理化、生物性能,安全性综合比较进行实验数据分析。 结果与结论：①在骨缺损修复过程中,从修复质量、免疫排斥和疾病传播等多方面来衡量,自体骨都是最佳的选择,成为骨移植的金标准。但来源有限且取骨区可能产生并发症,取骨又造成第二术区的创伤,因而它的临床应用受到了很大的限制。②同种异体骨的来源比自体骨多,但与宿主间的免疫排斥反应,并有感染疾病如肝炎病毒的可能。③人工骨材料成型迅速,在计算机辅助设计和辅助制作的帮助下,能更好的合成与缺损骨形态接近的骨修复替代材料,人工骨材料的骨诱导性和仿生物性骨结构方面还不能令人满意。④现有的骨修复替代材料均存在各自不同某些缺陷,不能完全满足临床质量的需要。未来能代替天然骨骼,解决骨缺损修复的材料应当是优势的组合,是骨修复替代材料的发展趋势。     

磷酸钙人工骨修复骨缺损的研究进展

继发于各类病因的大段骨缺损通常需要人工骨材料进行修复,目前常用的人工骨材料包括磷酸钙和硫酸钙基人工骨、生物活性玻璃等,以磷酸钙为主要成分的人工骨,复合其他一种或多种材料以期改善人工骨的性能是目前的研究热点。本文将总结以磷酸钙为基质的各类复合材料,包括与聚合物复合的磷酸钙材料、以磷酸钙为基质的合金材料、药物缓释材料以及骨组织工程材料在骨缺损修复中的研究进展,为以磷酸钙为基质新材料的研究奠定基础。     

亚微米拓扑结构磷酸三钙陶瓷的研制及骨诱导性能

背景：人工合成的磷酸钙陶瓷材料与天然骨组织无机成分相似,通过表面形貌和化学组成进行功能化设计可赋予其优异的骨传导和骨诱导性能,研发具有骨诱导性能的磷酸钙陶瓷材料是目前的研究热点。目的：通过材料形貌调控和功能化设计赋予亚微米拓扑结构磷酸三钙陶瓷骨诱导性能,检测其理化性能及骨诱导性能。方法：采用高温烧结法制备亚微米拓扑结构的磷酸三钙陶瓷,以市场可供商品化的骨修复材料Bio-Oss骨粉为对照组,表征两种材料的表面形貌、蛋白吸附能力及体外矿化性能。将第3代人牙周膜干细胞与两种材料浸提液共培养,采用CCK-8法检测细胞增殖,茜素红染色检测细胞矿化性能;将第3代人牙周膜干细胞分别接种至两种材料表面,采用碱性磷酸酶染色检测早期成骨,qR T-PCR检测成骨相关因子的表达。结果与结论：(1)扫描电镜下可见两种材料均具有颗粒状纹理的微孔表面,Bio-Oss颗粒明显小于磷酸三钙陶瓷,两种材料的总孔隙度、大孔隙度和微孔隙度相似,磷酸三钙陶瓷主要为亚微米级孔隙,晶粒粒径100 nm-1.0μm,Bio-Oss骨粉主要为纳米级孔隙;体外矿化实验显示,磷酸三钙陶瓷表面诱导骨磷灰石沉积的能力强于Bio-Oss骨粉;...     

磷酸钙骨水泥的生物学研究进展

本综述了磷酸钙骨水泥作为一种新型人工骨替代材料近年来的生物学基础及提高其生物学性能的研究,阐明了磷酸钙骨水泥以其良好的生物学特性,使其在骨缺损修复领域具有广阔的应用前景。     

Efficacité et performance des substituts osseux pour remplacer les allogreffes et autogreffes

Although bone tissue possesses the capacity for regenerative growth, the bone repair process is impaired in many clinical and pathological situations. For example massive bone loss caused by trauma and tumor resection as well as deformities require reconstructive surgery. In this context, there was a critical need to develop implant technologies to promote bone healing. Cortical and cancellous bone grafts are the materials of choice for bone filling or reconstruction, but their clinical use involves some difficulties. Septic complications, viral transmission and unavailability of native bone have therefore led to the development of synthetic bone substitutes. Allograft bone, or tissue harvested from a cadaver, while more readily available, may carry with it the risk of disease transmission and is also difficult to shape [1–3]. A significant additional limitation of allograft bone is the delayed remodeling by the host. In the case of very large defects, the allograft may remain in the implant site throughout the patient's life, creating an area more prone to fracture or infection. The development of calcium phosphate ceramics and other related biomaterials for bone graft involved a better control of the process of biomaterials resorption and bone substitution. Synthetic bone graft materials available as alternatives to autogeneous bone for repair, substitution or augmentation, in particular synthetic biomaterials include, special glass ceramics described as bioactive glasses; calcium phosphates (calcium hydroxyapatite, HA; tricalcium phosphate, TCP; and biphasic calcium phosphate, BCP). These materials differ in composition and physical properties from each other and from bone; and must be take in consideration for more efficient bone ingrowth at the expense of the biomaterials and to adapt to new development of dedicated biomaterials. In the last decade synthetic calcium phosphate materials, principally calcium hydroxyapatite (HA) ceramics, was commercially used. However the concept of bioactivity (release of ions of biological interest) well described for glass ceramic was not particularly take in account for HA and other related biomaterials(ACP Amorphous Calcium Phosphate, CdA Calcium Phosphate deficient Apatite). HA until recently was considered to be non able to be resorbed. Calcium phosphate biomaterials differ in their solubility or extent of dissolution: ACP > > α-TCP > > β-TCP > CdA > > ACP. These ceramics are osteoconductive (act as a support for new bone formation requiring the presence of porosity) and able to be resorbed (degradable through chemical and cellular processes). They are also biocompatible (do not induce adverse local tissue reaction, immunogenicity or systematically toxicity); and more recently, some papers report osteoinductive properties associated to the chemical nature (biphasic Ca P) and the microstruture. Past decade, these bioceramics have been marketed and approved for use in humans as bone substitutes. Various presentations are currently used in orthopaedic and maxillo-facial surgery such as wedges, blocks or granules. Owing to their bone substitution properties, CaP ceramics have naturally been considered as a potential matrix for tissue engineering and the development of a bioactive drug delivery system (DDS) in bone sites. The paper presents the current knowledge on Calcium phosphate bioceramics, Bone tissue engineering and Calcium Phosphate Drug Delivery.     

Inflammatory cell response to calcium phosphate biomaterial particles: An overview

Bone is a metabolically active and highly organized tissue consisting of a mineral phase of hydroxyapatite (HA) and amorphous calcium phosphate (CaP) crystals deposited in an organic matrix. One objective of bone tissue engineering is to mimic the chemical and structural properties of this complex tissue. CaP ceramics, such as sintered HA and beta-tricalcium phosphate, are widely used as bone substitutes or prosthesis coatings because of their osteoconductive properties. These ceramic interactions with tissues induce a cell response that can be different according to the composition of the material. In this review, we discuss inflammatory cell responses to CaP materials to provide a comprehensive overview of mechanisms governing the integration or loosening of implants, which remains a major concern in tissue engineering. A focus on the effects of the functionalization of CaP biomaterials highlights potential ways to increase tissue integration and limit rejection processes.     

医用聚醚醚酮材料骨整合改性的研究进展

聚醚醚酮（PEEK）材料具有良好的生物相容性、优异的机械性能、与骨组织相似的力学性能等优点,目前已广泛应用于临床各个领域。由于固有的生物惰性,使种植体与骨组织不相整合,从而限制了其作为骨科植入材料的应用。提高PEEK骨整合性成为目前研究的热点。研究者将具有促进成骨细胞增殖和分化的材料（如生物陶瓷、金属材料、生物因子等）通过物理或化学方式修饰于材料表面,或者采用表面物理修饰（如粗糙度、孔隙率、纳米结构等）提高其骨整合性。随着研究的逐步深入,PEEK的成骨活性得到增强,在临床上有了更大的应用前景。本文主要对上述提到的近些年用于提高PEEK生物活性的方法作一综述,旨在为研究者提供参考,并对未来发展提出展望。     

New tissue substitutes representing cortical bone and adipose tissue in quantitative radiology.

To employ quantitative radiology more accurately, we examined phantom materials for cortical bone and adipose tissue as calibration standards and as experimental phantoms. New tissue substitutes for cortical bone and adipose tissue composed of liquid phantom were verified by computing their attenuation coefficients and observing their chemical properties. We showed that a potassium pyrophosphate (K4P2O7) solution for cortical bone was comparable to a dipotassium hydrogen phosphate (K2HPO4) solution. Also, the use of methyl alcohol for adipose tissue was more suitable than ethyl alcohol as a phantom material because of its physical and chemical properties.     

磷酸三钙陶瓷材料形状对大鼠体内成血管化的影响

背景：组织工程人工骨支架材料的大体和微观结构可加速血管化进程。 目的：观察不同形状β-磷酸三钙陶瓷骨在体内的血管化程度,探索载体材料形状对体内血管化的影响。 方法：将柱状和管状两种β-磷酸三钙陶瓷骨材料分别植入SD大鼠两侧腰背筋膜下。 结果与结论：①同位素扫描结果：术后第3,6,12周,管状β-磷酸三钙陶瓷骨材料放射性核素骨显影放射性计数明显高于柱状β-磷酸三钙陶瓷骨材料(P < 0.05),并且随着时间的延长,两组放射性核素骨显影放射性计数均呈上升趋势。②扫描电镜观察结果：第3周时,材料外形保持良好,宿主纤维组织和血管由材料外周向内生长;术后6周时,管状材料内小血管增生活跃,且分布比较均匀,柱状材料血管增生主要集中在外周部分;术后12周时,两组材料血管化程度更高,管状材料外周及中心部位均可见较为成熟的纤维组织和丰富血管网,但柱状材料纤维组织和血管主要集中在外周部分,中轴部分较少。表明管状三维结构β-磷酸三钙陶瓷骨材料较柱状材料更利于体内血管化。     

Review paper: behavior of ceramic biomaterials derived from tricalcium phosphate in physiological condition

Various calcium phosphates are used for bone repair. Although hydroxyapatite (HA) sintered ceramics are widely used due to their osteoconductivity, its bioresorbability is so low that HA remains in the body for a long time after implantation. In contrast, tricalcium phosphate (TCP) ceramics show resorbable characters during bone regeneration, and can be completely substituted for the bone tissue after stimulation of bone formation. Therefore, much attention is paid to TCP ceramics for scaffold materials for supporting bone regeneration. This paper reviews bioresorbable properties of calcium phosphate ceramics derived from beta-TCP and alpha-TCP.     

Natural rubber latex coated with calcium phosphate for biomedical application

Natural rubber latex (NRL) is a flexible biomembrane that possesses angiogenic properties and has recently been used for guided bone regeneration, enhancing healing without fibrous tissue, allergies or rejection. Calcium phosphate (Ca/P) ceramics have chemical, biological, and mechanical properties similar to mineral phase of bone, and ability to bond to the host tissue, although it can disperse from where it is applied. Therefore, to create a composite that could enhance the properties of both materials, NRL biomembranes were coated with Ca/P. NRL biomembranes were soaked in 1.5 times concentrated SBF solution for seven days, avoiding the use of high temperatures. SEM showed that Ca/P has been coated in NRL biomembrane, XRD showed low crystallinity and FTIR showed that is the carbonated type B. Furthermore, hemolysis of erythrocytes, quantified spectrophotometrically using materials (Ca/P, NRL, and NRL + Ca/P) showed no hemolytic effects up to 0.125 mg/mL (compounds and mixtures), indicating no detectable disturbance of the red blood cell membranes. The results show that the biomimetic is an appropriate method to coat NRL with Ca/P without using high temperatures, aiming a new biomembrane to improve guided bone regeneration.     

Resorbable bioceramics based on stabilized calcium phosphates. Part II: evaluation of biological response

Synthetic materials capable of being remodelled in vivo by the same processes responsible for natural bone turnover have long been sought for use as an artificial bone substitute. These materials must ideally combine osteoinductive capacity with the ability to withstand random dissolution at normal physiological pH, while being resorbed by natural cell-mediated processes. Resorbable calcium phosphate based coatings and bulk ceramics have been developed which promote the uniform deposition of new mineralized bone matrix thus enabling rapid integration with the surrounding host bone tissue in vivo. Furthermore, a critical result of this study is the determination that the silicon-stabilized calcium phosphate ceramics are essentially insoluble in biological media but are resorbed when acted upon by osteoclasts. In vitro biological testing and preliminary in vivo testing show that the important features of this new biomaterial are a characteristic calcium phosphate phase composition and a unique microporous morphology.     

Calcium phosphate ceramics in bone tissue engineering: A review of properties and their influence on cell behavior

Calcium phosphate ceramics (CPCs) have been widely used as biomaterials for the regeneration of bone tissue because of their ability to induce osteoblastic differentiation in progenitor cells. Despite the progress made towards fabricating CPCs possessing a range of surface features and chemistries, the influence of material properties in orchestrating cellular events such as adhesion and differentiation is still poorly understood. Specifically, questions such as why certain CPCs may be more osteoinductive than others, and how material properties contribute to osteoinductivity/osteoconductivity remain unanswered. Therefore, this review article systematically discusses the effects of the physical (e.g. surface roughness) and chemical properties (e.g. solubility) of CPCs on protein adsorption, cell adhesion and osteoblastic differentiation in vitro. The review also provides a summary of possible signaling pathways involved in osteoblastic differentiation in the presence of CPCs. In summary, these insights on the contribution of material properties towards osteoinductivity and the role of signaling molecules involved in osteoblastic differentiation can potentially aid the design of CPC-based biomaterials that support bone regeneration without the need for additional biochemical supplements.     

Phenotypic expression of bone-related genes in osteoblasts grown on calcium phosphate ceramics with different phase compositions

Calcium phosphate ceramics with different hydroxyapatite (HA) and tricalcium phosphate (TCP) ratios have different chemical properties. Does the difference in phase composition affect osteoblast behavior? In this study, osteoblasts were cultured on 4 kinds of calcium phosphate ceramics, i.e. pure (HA), HT1 (HA/TCP, 70/30), HT2 (HA/TCP, 35/65), and pure TCP. Cell proliferation of SaOS-2 cells together with bone-related genes' mRNA expression and protein production in osteoblasts cultured on different calcium phosphate ceramics were detected at different time points. Data suggested that cell proliferation rate on TCP ceramics was lower than that on the other substrates tested. Generally, mRNA expressions for osteonectin and osteocalcin were similar among the four kinds of ceramics in most circumstances, whereas at six days, alkaline phosphatase mRNA expression was higher on HA and HT1 surfaces than on the other two materials. Collagen I mRNA expression was also affected by the phase composition of substrates. Osteocalcin and bone sialoprotein production in SaOS-2 cells was very similar no matter which ceramic surface the cells were grown upon. This study revealed that calcium phosphate ceramics substrate could support osteoblast growth and bone-related gene expression and its gene expression pattern explained the basis of the biocompatibility and bioactivity for calcium phosphate ceramics.